Evidence map›Paper›PMID 26453463›Full record

SynthesisEuropean journal of clinical pharmacology2016

The impact of switching P2Y12 receptor inhibitor therapy during index hospitalization: a systematic review.

Jaya Chandrasekhar, Benjamin Hibbert, Michael Froeschl, Derek So, Roxana Mehran, Michel Le May, CAPITAL investigators

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Short term outcome following acute phase switch among P2YInternational journal of cardiology. Heart & vasculature · 2019
    Article
  2. Comparative Review of Oral P2YP & T : a peer-reviewed journal for formulary management · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Jaya ChandrasekharDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada. jayachandrasekhar@hotmail.co.uk.
Benjamin HibbertDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada.
Michael FroeschlDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada.
Derek SoDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada.
Roxana MehranDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada.
Michel Le MayDivision of Cardiology, University of Ottawa Heart Institute, CAPITAL Research Group, Ottawa, Ontario, Canada.
CAPITAL investigators
University of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWith the availability of novel P2Y12 receptor inhibitors, patients presenting with acute coronary syndrome (ACS) may receive more than one type of this drug during index hospitalization. We sought to determine the effect of switching from clopidogrel to a novel P2Y12 receptor inhibitor on the occurrence of major adverse cardiovascular events (MACE) and bleeding.

methodsWe conducted a literature search on SCOPUS for English language entries until 7 March 2015. Out of 188 citations, seven studies encompassing 16,431 patients were selected for analysis of (i) switching to a novel P2Y12 agent (switching group) versus continued clopidogrel or (ii) switching to a novel P2Y12 agent (switching group) versus upfront novel agent initiation during index hospitalization

resultsMACE was significantly lower in the switching group (odds ratio (OR) 0.77, 95 % confidence interval (CI) 0.63-0.96, p = 0.02), whereas bleeding was higher (OR 1.55, 1.29-1.85, p < 0.01) compared with continued clopidogrel. Conversely, MACE was similar with switching to a novel agent and upfront novel therapy initiation (OR 1.01, 95 % CI 0.8-1.29, p = 0.90), but bleeding was higher in the switching group (OR 1.24, 95 % CI 1.03-1.48, p = 0.02).

conclusionsThe current study suggests that switching to a novel P2Y12 agent in patients with ACS and/or patients undergoing coronary stenting is more efficacious than continuing clopidogrel. In this cohort, switching to a novel agent did not result in worse ischemic outcomes than upfront initiation of novel therapies. However, switching was associated with greater bleeding compared with both continued clopidogrel as well as upfront use of novel P2Y12 agents.

Indexed as

Cardiovascular DiseasesClopidogrelHemorrhageHospitalizationHumansPurinergic P2Y Receptor AntagonistsTiclopidineClopidogrelPurinergic P2Y Receptor AntagonistsTiclopidineAcute coronary syndromeP2Y12 receptor blockersPercutaneous coronary interventionSwitching

Identifiers

PMID26453463
OpenAlexW2102338684

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.