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Efficacy and Safety of High Potent P2Y 12 Inhibitors Prasugrel and Ticagrelor in Patients With Coronary Heart Disease Treated With Dual Antiplatelet Therapy: A Sex-Specific Systematic Review and Meta-Analysis.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2020 Feb 18; Vol. 9 (4), pp. e014457. Date of Electronic Publication: 2020 Feb 17. - Publication Year :
- 2020
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Abstract
- Background Sex differences in efficacy and safety of dual antiplatelet therapy remain uncertain because of the underrepresentation of women in cardiovascular trials. The aim of this study was to perform a sex-specific analysis of the pooled efficacy and safety data of clinical trials comparing a high potent P2Y <subscript>12</subscript> inhibitor+aspirin with clopidogrel+aspirin in patients with acute coronary syndrome. Methods and Results A systematic literature search was performed. Randomized clinical trials that compared patients following percutaneous coronary intervention/acute coronary syndrome who were taking high potent P2Y <subscript>12</subscript> inhibitors+aspirin versus clopidogrel+aspirin were selected. Random effects estimates were calculated and relative risks with 95% CIs on efficacy and safety end points were determined per sex. We included 6 randomized clinical trials comparing prasugrel/ticagrelor versus clopidogrel in 43 990 patients (13 030 women), with a median follow-up time of 1.06 years. Women and men had similar relative risk (RR) reduction for major cardiovascular events (women: RR, 0.89 [95% CI, 0.80-1.00; men: RR, 0.84 [95% CI, 0.79-0.91) ( P for interaction=0.39). Regarding safety, women and men had similar risk of major bleeding by high-potency dual antiplatelet therapy (RR, 1.18 [95% CI, 0.98-1.41] versus RR, 1.03 [95% CI, 0.93-1.14]) ( P for interaction=0.20). Conclusions The small and statistically insignificant difference in efficacy and safety estimates of high-potency dual antiplatelet therapy between women and men following percutaneous coronary intervention/acute coronary syndrome do not justify differential dual antiplatelet therapy treatment for both sexes.
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 9
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 32063118
- Full Text :
- https://doi.org/10.1161/JAHA.119.014457