The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis.
<h4>Background</h4>The function of coronary microcirculation is an important factor in predicting the prognosis of patients with acute coronary syndrome (ACS) who receive percutaneous coronary intervention (PCI) therapy. Ticagrelor, a type of oral P2Y12 inhibitor, is widely prescribed to...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0289243 |
| _version_ | 1797690882765357056 |
|---|---|
| author | Xiaohan Qiu Xiaohui Li Kang Fu Wentao Chen Wenqiang Chen |
| author_facet | Xiaohan Qiu Xiaohui Li Kang Fu Wentao Chen Wenqiang Chen |
| author_sort | Xiaohan Qiu |
| collection | DOAJ |
| description | <h4>Background</h4>The function of coronary microcirculation is an important factor in predicting the prognosis of patients with acute coronary syndrome (ACS) who receive percutaneous coronary intervention (PCI) therapy. Ticagrelor, a type of oral P2Y12 inhibitor, is widely prescribed to ACS patients and can improve prognosis compared to clopidogrel. However, the efficacy of ticagrelor on coronary microcirculation, compared to clopidogrel, remains unclear. The objective of this meta-analysis was to determine the efficacy of ticagrelor on coronary microcirculation.<h4>Methods</h4>The PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were comprehensively searched to identify studies until November 2022. Data was pooled using the fixed effects model or random effects model based on the level of heterogeneity. Sensitivity analyses were performed to measure the effects of potential confounders.<h4>Results</h4>After screening, 16 trials with a total of 3676 participants were ultimately included in the analysis. The meta-analysis revealed that compared to clopidogrel, patients receiving ticagrelor exhibited a more significant reduction in the IMR (WMD: -6.23, 95% CI: -8.41 to -4.04), a reduction in the cTFC (WMD: -1.88; 95% CI: -3.32 to -0.45), and greater increases in CFR (WMD: 0.38; 95% CI: 0.18 to 0.57), MBG (RR 1.29, 95% CI 1.12 to 1.48), and TIMI (RR 1.03, 95% CI 1.00 to 1.06).<h4>Conclusion</h4>Our findings suggest that, compared to clopidogrel, ticagrelor has a significant effect in reducing coronary microcirculatory resistance, enhancing coronary blood flow reserve, and improving myocardial perfusion. |
| first_indexed | 2024-03-12T02:05:30Z |
| format | Article |
| id | doaj.art-b6c294a8b13f4afb88dcecf1a37f5bba |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-12T02:05:30Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b6c294a8b13f4afb88dcecf1a37f5bba2023-09-07T05:31:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188e028924310.1371/journal.pone.0289243The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis.Xiaohan QiuXiaohui LiKang FuWentao ChenWenqiang Chen<h4>Background</h4>The function of coronary microcirculation is an important factor in predicting the prognosis of patients with acute coronary syndrome (ACS) who receive percutaneous coronary intervention (PCI) therapy. Ticagrelor, a type of oral P2Y12 inhibitor, is widely prescribed to ACS patients and can improve prognosis compared to clopidogrel. However, the efficacy of ticagrelor on coronary microcirculation, compared to clopidogrel, remains unclear. The objective of this meta-analysis was to determine the efficacy of ticagrelor on coronary microcirculation.<h4>Methods</h4>The PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were comprehensively searched to identify studies until November 2022. Data was pooled using the fixed effects model or random effects model based on the level of heterogeneity. Sensitivity analyses were performed to measure the effects of potential confounders.<h4>Results</h4>After screening, 16 trials with a total of 3676 participants were ultimately included in the analysis. The meta-analysis revealed that compared to clopidogrel, patients receiving ticagrelor exhibited a more significant reduction in the IMR (WMD: -6.23, 95% CI: -8.41 to -4.04), a reduction in the cTFC (WMD: -1.88; 95% CI: -3.32 to -0.45), and greater increases in CFR (WMD: 0.38; 95% CI: 0.18 to 0.57), MBG (RR 1.29, 95% CI 1.12 to 1.48), and TIMI (RR 1.03, 95% CI 1.00 to 1.06).<h4>Conclusion</h4>Our findings suggest that, compared to clopidogrel, ticagrelor has a significant effect in reducing coronary microcirculatory resistance, enhancing coronary blood flow reserve, and improving myocardial perfusion.https://doi.org/10.1371/journal.pone.0289243 |
| spellingShingle | Xiaohan Qiu Xiaohui Li Kang Fu Wentao Chen Wenqiang Chen The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. PLoS ONE |
| title | The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. |
| title_full | The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. |
| title_fullStr | The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. |
| title_full_unstemmed | The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. |
| title_short | The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis. |
| title_sort | effect of ticagrelor on coronary microvascular function after pci in patients with acs compared to clopidogrel a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0289243 |
| work_keys_str_mv | AT xiaohanqiu theeffectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT xiaohuili theeffectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT kangfu theeffectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT wentaochen theeffectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT wenqiangchen theeffectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT xiaohanqiu effectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT xiaohuili effectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT kangfu effectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT wentaochen effectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis AT wenqiangchen effectofticagreloroncoronarymicrovascularfunctionafterpciinpatientswithacscomparedtoclopidogrelasystematicreviewandmetaanalysis |