Ticagrelor versus clopidogrel in East-Asian patients with acute coronary syndromes: a meta-analysis of randomized trials.

AIM

To determine whether ticagrelor or clopidogrel provides the best outcomes for East-Asian patients with acute coronary syndrome (ACS).

MATERIALS & METHODS: Identification and interrogation of electronic databases through 26 July 2016 revealed fully randomized and controlled trials wherein primary efficacy end points were major adverse cardiovascular events and all-cause death among East-Asian patients with ACS. Major bleeding and noncoronary artery bypass grafts major bleeding were primary safety end points.

RESULTS

Two studies met the inclusion criteria. Compared with clopidogrel, ticagrelor has no statistical difference in the end points of major adverse cardiovascular events (risk ratio [RR]: 1.08; 95% CI: 0.62-1.91; p = 0.7260), myocardial infarction (RR: 1.200; 95% CI: 0.64-2.24; p = 0.5669), stroke (RR: 1.11; 95% CI: 0.46-2.66; p = 0.8165), cardiovascular death (RR: 0.89; 95% CI: 0.48-1.65; p = 0.7150), or all-cause mortality (RR: 0.92; 95% CI: 0.43-1.96; p = 0.8252). When compared with clopidogrel, it was found that ticagrelor provoked marked increases in major bleeding (RR: 1.48; p = 0.0430) and noncoronary artery bypass grafts-associated major bleeding (RR: 1.62; p = 0.0454).

CONCLUSION

Ticagrelor and clopidogrel displayed similar efficacies in ACS presenting patients from East Asia. Administration of ticagrelor also displays some side effects including an increased risk of major bleeding.