The Anatolian Journal of Cardiology
Meta Analysis

Efficacy and Safety of Ticagrelor in East Asian Patients with Acute Coronary Syndrome: A Meta-Analysis of Randomized Controlled Trials


Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China


Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China

Anatol J Cardiol 2022; 26: 434-441
DOI: 10.5152/AnatolJCardiol.2022.1144
Read: 76 Downloads: 36 Published: 01 June 2022

Background: Although current guidelines recommend ticagrelor to clopidogrel for patients with acute coronary syndrome, its benefit and risk are unclear for East Asians. This meta-analysis was performed to assess the efficacy and safety of ticagrelor in East Asian patients with acute coronary syndrome.

Methods: Medline, EMBASE, and Cochrane Databases were searched from inception to July, 2021, for randomized controlled trials comparing ticagrelor with clopidogrel in East Asian patients with acute coronary syndrome. Major adverse cardiovascular events and bleeding events were assessed by using Mantel-Haenszel-pooled risk ratio and 95% con- fidence interval.

Results: Five randomized controlled trials identified 2752 patients with acute coronary syndrome. Compared with clopidogrel, ticagrelor had no statistical difference of major adverse cardiovascular events (RR 0.87; 95% CI 0.52-1.45; P = .58), all cause death (RR 0.90, 95% CI 0.62-1.32; P = .60), cardiovascular death (RR 0.90, 95% CI 0.47-1.72; P = .74), myo- cardial infarction (RR 0.91, 95% CI 0.52-1.58; P = .73), and stroke (RR 0.87, 95% CI 0.48-1.57; P = .64). Despite ticagrelor did not increase the incidence of fatal bleeding (RR 2.49, 95% CI 0.79-7.87; P = 0.12), the risks of all bleeding (RR 1.71, 95% CI 1.36-2.16; P < .00001), major bleeding (RR 1.51, 95% CI 1.12-2.04; P = .007), non-coronary artery bypass grafting major bleeding (RR 1.83, 95% CI 1.23-2.71; P = .003), and minor bleeding (RR 1.92, 95% CI 1.40-2.64; P < .0001) were significantly higher.

Conclusions: Although there was no significant difference in the incidence of fatal bleed- ing, ticagrelor displayed similar efficacy and dramatically increased the risk of otherbleeding events.

Cite this article as: Xie C, Lin J, Qin Q, Zhu J. Efficacy and safety of ticagrelor in east asian patients with acute coronary syndrome: A meta-analysis of randomized controlled trials. Anatol J Cardiol. 2022;26(6):434-441.

ISSN 2149-2263 EISSN 2149-2271