1. Ticagrelor for prevention of stroke and cognitive impairment in patients with vascular high-risk factors: A meta-analysis of randomized controlled trials.
- Author
-
Li, Xiaohui, Jia, Zetian, and Yan, Yaqi
- Subjects
- *
TRANSIENT ischemic attack , *RANDOMIZED controlled trials , *MULTI-infarct dementia , *PERIPHERAL vascular diseases , *TICAGRELOR , *COGNITION disorders , *ANKLE brachial index - Abstract
In recent randomized controlled studies, the prevention of stroke and cognitive function of ticagrelor has been controversial. We conducted a meta-analysis to compare ticagrelor with other antiplatelet treatment in patients with vascular high-risk factors disease, defined as acute coronary syndrome, stroke or transient ischemic attack, coronary artery disease or peripheral artery disease. We searched the PubMed, Embase, and Cochrane libraries for published randomized controlled trials and additional available data from ClinicalTrials.gov. The primary outcome was related adverse stroke events and the secondary outcome was cognitive function related adverse events. The outcomes were statistically analyzed using Peto odds ratio. 12 RCTs with 105,654 patients were included in meta-analysis. Primary outcomes: all stroke (OR 0.84, 95%CI 0.78–0.90, P < 0.001); Secondary outcomes: ischemic stroke (OR 0.83, 95%CI 0.77–0.90, P < 0.001), transient ischemic attack (OR 0.78, 95%CI 0.62–0.97, P = 0.029), intracranial hemorrhage (OR 1.33, 95%CI 1.09–1.61, P = 0.005), Parkinson's disease (OR 0.30, 95%CI 0.12–0.72, P = 0.007), dementia (OR 0.31, 95%CI 0.13–0.77, P = 0.012), dizziness (OR: 1.39, 95%CI 1.03–1.87, P = 0.032), insomnia (OR 1.45, 95%CI 1.05–2.00, P = 0.026). Ticagrelor may provide more favorable outcomes for all stroke, ischemic stroke, and transient ischemic attack prevention in patients with vascular high-risk factors. However, this benefit may come with the cost of intracranial hemorrhage, dizziness and insomnia. Ticagrelor may reduce the risk of dementia and Parkinson's disease, although available data are limited. • Ticagrelor reduces the risk of all-cause stroke, ischemic stroke and TIA in patients with vascular high-risk factors; • Ticagrelor may reduce the risk of dementia and Parkinson's disease in patients with vascular high-risk factors; • Ticagrelor is a highly potent platelet drug that does not increase the risk of death; • Ticagrelor still needs to be further studied on its effect on cognitive function. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF