Evidence map›Paper›PMID 32468837›Full record

ArticleCirculation2020

Comparative Efficacy and Safety of Oral P2Y

Eliano P Navarese, Safi U Khan, Michalina Kołodziejczak, Jacek Kubica, Sergio Buccheri, Christopher P Cannon, Paul A Gurbel, Stefano De Servi, Andrzej Budaj, Antonio Bartorelli and 5 more

Open access · bronzeAbstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 14 pooled it
15.3field-weighted citation impact, top 1% 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

72 citing papers in PubMed, 14 syntheses or guidelines pooled it, 140 citations in OpenAlex.

  1. Personalized Antithrombotic Therapy After Percutaneous Coronary Intervention: A Systematic Review of Risk-Stratified Approaches.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
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  7. Abbreviated versus Standard Duration of DAPT after PCI: A Systematic Review and Network Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
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  10. Early vs. Delayed Initiation of Treatment With P2YFrontiers in cardiovascular medicine · 2022
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 5 countries.

Eliano P NavareseDepartments of Cardiology and Internal Medicine (E.P.N., J.K.), Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland.
Safi U KhanDepartment of Internal Medicine, West Virginia University, Morgantown (S.U.K.).
Michalina KołodziejczakAnaesthesiology and Intensive Care (M.K.), Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland.
Jacek KubicaDepartments of Cardiology and Internal Medicine (E.P.N., J.K.), Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland.
Sergio BuccheriDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Sweden (S.B., L.W., S.J.).
Christopher P CannonHarvard Clinical Research Institute, Boston, MA (C.P.C.).
Paul A GurbelSinai Center for Thrombosis Research, Sinai Hospital of Baltimore, LifeBridgehealth, MD (P.A.G.).
Stefano De ServiIRCCS Multimedica, Sesto San Giovanni, Milan, Italy (S.D.S.).
Andrzej BudajCentre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland (A. Budaj).
Antonio BartorelliCentro Cardiologico Monzino, University of Milan, Italy (A. Bartorelli, D.T.).
Daniela TrabattoniCentro Cardiologico Monzino, University of Milan, Italy (A. Bartorelli, D.T.).
E Magnus OhmanDivision of Cardiology, Duke University Medical Center, Durham, NC (E.M.O., M.T.R.).
Lars WallentinDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Sweden (S.B., L.W., S.J.).
Matthew T RoeDivision of Cardiology, Duke University Medical Center, Durham, NC (E.M.O., M.T.R.).
Stefan JamesDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Sweden (S.B., L.W., S.J.).
Uppsala University Hospital · SECentro Cardiologico Monzino · ITDuke University · USNicolaus Copernicus University · PLBaim Institute for Clinical Research · USGrochowski Hospital · PLMultiMedica · ITSinai Hospital · USUniversity of Alberta · CAWest Virginia University · US

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Laura F. Gibson · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundNew randomized, controlled trials have become available on oral P2Y

methodsWe performed a network meta-analysis and direct pairwise comparison analysis of efficacy and safety outcomes from 12 randomized controlled trials including a total of 52 816 patients with acute coronary syndrome.

resultsIn comparison with clopidogrel, ticagrelor significantly reduced cardiovascular mortality (hazard ratio [HR], 0.82 [95% CI, 0.72-0.92]) and all-cause mortality (HR, 0.83 [95% CI, 0.75-0.92]), whereas there was no statistically significant mortality reduction with prasugrel (HR, 0.90 [95% CI, 0.80-1.01] and HR, 0.92 [95% CI, 0.84-1.02], respectively). In comparison with each other, there were no significant differences in mortality (HR prasugrel versus ticagrelor, 1.10 [95% CI, 0.94-1.29] and 1.12 [95% CI, 0.98-1.28]). In comparison with clopidogrel, prasugrel reduced myocardial infarction (HR, 0.81 [95% CI, 0.67-0.98]), whereas ticagrelor showed no risk reduction (HR, 0.97 [95% CI, 0.78-1.22]). Differences between prasugrel and ticagrelor were not statistically significant. Stent thrombosis risk was significantly reduced by both ticagrelor and prasugrel versus clopidogrel (28%-50% range of reduction). In comparison with clopidogrel, both prasugrel (HR, 1.26 [95% CI, 1.01-1.56]) and ticagrelor (HR, 1.27 [95% CI, 1.04-1.55]) significantly increased major bleeding. There were no significant differences between prasugrel and ticagrelor for all outcomes explored.

conclusionsPrasugrel and ticagrelor reduced ischemic events and increased bleeding in comparison with clopidogrel. A significant mortality reduction was observed with ticagrelor only. There was no efficacy and safety difference between prasugrel and ticagrelor. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42019155648.

Indexed as

Acute Coronary SyndromePlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsThrombosisCause of DeathHemorrhageHumansPercutaneous Coronary InterventionPrognosisRandomized Controlled Trials as TopicTreatment OutcomePlatelet Aggregation InhibitorsPurinergic P2Y Receptor Antagonistsacute coronary syndromemeta-analysisP2Y12 protein, human

Identifiers

PMID32468837
PMCPMC7489363
OpenAlexW3031115393

What OpenQuestion holds

Textmetadata
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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.