Supplementary File
收藏DataCite Commons2025-07-17 更新2025-09-08 收录
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<b>Introduction: </b>Acute coronary syndrome (ACS) results from sudden, reduced blood flow to the heart due to coronary artery blockages. Dual antiplatelet therapy (DAPT) with aspirin and P2Y₁₂ inhibitor is standard post-percutaneous coronary intervention (PCI) to prevent thrombosis. Clopidogrel, a widely used P2Y₁₂ inhibitor, shows reduced efficacy in some patients due to genetic variability. Ticagrelor has emerged as a potential alternative in DAPT for ACS post-PCI. <b>Objective: </b>To evaluate the efficacy and safety of ticagrelor compared to clopidogrel as DAPT for ACS patients post-PCI through outcome cardiovascular death, myocardial infarction, stent thrombosis, target revascularization, dyspnea, and major bleeding.<b>Method: </b>A systematic search was conducted through databases PubMed, Scopus, Cochrane, Epistemonikos, ClinicalTrials.gov, ProQuest, Scilit, and Google Scholar. The quality of the included studies was assessed using the Cochrane RoB 2.0 tool. Using a random-effects model, we examined pooled risk ratio with 95% confidence intervals were analyze using RevMan 5.4 and RStudio software.<b>Result and discussion: </b>Eight RCTs (n = 1,726) showed that ticagrelor significantly reduced the incidence of myocardial infarction (RR = 0.44 [95% CI: 0.21–0.91], p = 0.03; I<sup>2 </sup>=0%), stent thrombosis (RR = 0.30 [95% CI: 0.14–0.66], p=0.0027; I<sup>2</sup>=0%), and target revascularization (RR = 0.47 [95% CI: 0.26–0.83], p = 0.0098; I<sup>2 </sup>= 0%). No significant difference was observed in cardiovascular death (RR = 0.54 [95% CI: 0.27–1.06], p = 0.00733; I<sup>2 </sup>= 0%). In the safety analysis, dyspnoea was more frequently reported in the ticagrelor group (RR = 6.20 [95% CI: 1.10–35.04], p = 0.039; I<sup>2</sup> = 0%). In addition, no significant difference was found in the incidence of major bleeding (RR = 1.05 [95% CI: 0.43–2.54], p = 0.9176; I<sup>2 </sup>= 0%).<b>Conclusion: </b>Ticagrelor is more effective than clopidogrel as DAPT in patients with ACS post-PCI. No serious adverse effects were identified with ticagrelor use. Future studies are needed with longer follow-up periods, more diverse patient populations, and broader adverse events
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figshare
创建时间：
2025-07-17
