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High on‐treatment platelet reactivity with ticagrelor versus prasugrel: a systematic review and meta‐analysis
Author(s) -
Lemesle G.,
Schurtz G.,
Bauters C.,
Hamon M.
Publication year - 2015
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12907
Subject(s) - ticagrelor , prasugrel , medicine , clopidogrel , platelet , randomized controlled trial , p2y12 , meta analysis , cardiology , aspirin
Summary Background Ticagrelor and prasugrel have shown superiority over clopidogrel. However, it remains unclear if one is superior to another regarding on‐treatment platelet reactivity. Objectives To compare the impact of ticagrelor and prasugrel on high on‐treatment platelet reactivity ( HTPR ). Methods The PubMed and Cochrane databases were searched for eligible studies in December 2014. Studies were eligible if they compared ticagrelor and prasugrel regarding high on‐treatment platelet reactivity ( HTPR ). Pooled estimates were calculated by using a random‐effects model with 95% confidence intervals. Results We included 14 studies and 1822 patients: 805 and 1017 in the ticagrelor and prasugrel groups, respectively. The rate of HTPR was significantly lower in the ticagrelor group: 1.5% vs. 9.8% ( RR = 0.27 [0.14–0.50]). The pre‐specified analysis focusing on randomized trials ( n = 10) showed consistent results ( RR = 0.27 [0.12–0.60]). Conclusion Our results suggest that ticagrelor allows a higher platelet reactivity inhibition as compared with prasugrel and leads to a further decrease in the rate of HTPR .