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Xie ZJ, Xin SL, Chang C, Zhou HJ, Zhao XF, Liu LJ, Jiao FH, Chen C, Li T. [Efficacy and safety of ticagrelor versus clopidogrel in Chinese patients with acute coronary syndrome treated with glycoprotein Ⅱb/Ⅲa receptor antagonist]. Zhonghua Nei Ke Za Zhi 2021; 60:544-551. [PMID: 34058811 DOI: 10.3760/cma.j.cn112138-20200814-00756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the efficacy and safety of ticagrelor versus clopidogrel in acute coronary syndrome (ACS) Chinese patients using glycoprotein Ⅱb/Ⅲa inhibitor (GPI). Methods: The data from CCC-ACS (Improving Care for Cardiovascular Disease in China-ACS) project were systematically reviewed in ACS patients with GPI. The patients were divided into ticagrelor and clopidogrel groups. A logistic analysis and propensity score matching (PSM) were performed to compare occurrences of major cardiovascular events (MACE) and bleeding events between the two groups during hospitalization. Results: A total of 63 641 ACS patients were collected from 150 hospitals. Logistic regression analyses showed that there was no statistically significant difference in the reduction of MACE between ticagrelor and clopidogrel when using GPI (OR=0.881, 95%CI 0.599-1.296; P=0.521). However, major bleeding rate was higher in the ticagrelor group than that in the clopidogrel group (OR=1.401, 95%CI 1.075-1.852; P=0.013). Similar results were observed after PSM. No statistic difference in MACE between the ticagrelor and clopidogrel group (OR=0.919, 95%CI 0.613-1.376; P=0.681). Major bleeding rate was higher in the ticagrelor group (OR=1.559, 95%CI 1.130-2.150; P=0.007). Conclusion: In ACS patients with GPI, ticagrelor did not reduce MACE, but increased the major bleeding risk compared with clopidogrel.
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Affiliation(s)
- Z J Xie
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - S L Xin
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - C Chang
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - H J Zhou
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - X F Zhao
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - L J Liu
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - F H Jiao
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - C Chen
- Department of Cardiology, Handan First Hospital, Handan, Hebei 056002, China
| | - T Li
- Department of Cardiology, Handan Central Hospital, Handan, Hebei 056001, China
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