Evidence map›Paper›PMID 29934940›Full record

SynthesisJournal of thrombosis and thrombolysis2018

Ticagrelor versus clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.

Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Mahmoud Barbarawi, Yazan Zayed, Michael Hicks, Sahar Ahmed, Ghassan Bachuwa, Mustafa Hassan and 1 more

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of thrombosis and thrombolysis, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 6 pooled it
–field-weighted citation impact
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

9 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Ideal P2Y12 Inhibitor in Acute Coronary Syndrome: A Review and Current Status.International journal of environmental research and public health · 2022
    Review
  8. Article
  9. Review
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

11 authors.

Babikir KheiriDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Mohammed OsmanDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Ahmed AbdallaDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Tarek HaykalDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Mahmoud BarbarawiDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Yazan ZayedDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Michael HicksDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Sahar Ahmed, Flint, MI, USA.
Ghassan BachuwaDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Mustafa HassanDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Deepak L BhattBrigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. dlbhattmd@post.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dual antiplatelet therapy with aspirin and clopidogrel are recommended as adjuncts to fibrinolytic-treated patients with ST-elevation myocardial infarction (STEMI). However, the role of switching to ticagrelor within 24 h of fibrinolytics compared with clopidogrel continuation in this setting is uncertain. Hence, we conducted a comprehensive search of electronic databases for all randomized clinical trials (RCTs) that evaluated the safety and efficacy of ticagrelor versus clopidogrel after fibrinolytic therapy in patients with STEMI. A random-effects model was used to calculate the risk ratios (RRs) and 95% confidence intervals (CIs). A total of 5 RCTs that evaluated the efficacy of ticagrelor post-fibrinolysis were identified. We included 3 RCTs with 3999 total patients for our meta-analysis. The results showed similar short-term clinical outcomes between ticagrelor and clopidogrel with regard to rates of Bleeding Academic Research Consortium (BARC) type ≥ 2 bleeding (RR 0.94; 95% CI 0.56-1.60; P = 0.83), major adverse cardiovascular events (RR 0.87; 95% CI 0.49-1.52; P = 0.62), mortality (RR 0.92; 95% CI 0.53-1.59; P = 0.77), myocardial infarction (RR 0.76; 95% CI 0.43-1.36; P = 0.36), and stroke (RR 0.93; 95% CI 0.50-1.73; P = 0.82). Our results demonstrate that in STEMI patients treated with fibrinolytic therapy, switching to ticagrelor was associated with similar bleeding and ischemic outcomes compared with clopidogrel continuation.

Indexed as

Cardiovascular DiseasesClopidogrelHemorrhageHumansPlatelet Aggregation InhibitorsRandomized Controlled Trials as TopicST Elevation Myocardial InfarctionStrokeSurvival AnalysisThrombolytic TherapyTicagrelorClopidogrelPlatelet Aggregation InhibitorsTicagrelorAcute coronary syndromeFibrinolysisP2Y12STEMIThrombolysisTicagrelor

Identifiers

PMID29934940

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.