Evidence map›Paper›PMID 34643836›Full record

SynthesisCardiovascular drugs and therapy2023

Comparative Safety and Effectiveness of Loading Doses of P2Y12 Inhibitors in Patients Undergoing Elective PCI: a Network Meta-analysis.

Rahul Gupta, Aaqib H Malik, Alexandros Briasoulis, Amogh M Joshi, Desire G Guthier, Tarun Popli, Wilbert S Aronow, Apurva V Vyas, Nainesh C Patel, Hasan Ahmad and 1 more

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular drugs and therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 38% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. 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 at 3 institutions in 1 country.

Rahul GuptaLehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA. rgupta8687@gmail.com.ORCID 0000-0002-2511-2119
Aaqib H MalikDepartment of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Alexandros BriasoulisDivision of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Amogh M JoshiLehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA.
Desire G GuthierDepartment of Internal Medicine, Lehigh Valley Health Network, Allentown, PA, USA.
Tarun PopliDepartment of Internal Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Wilbert S AronowDepartment of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Apurva V VyasLehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA.
Nainesh C PatelLehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA.
Hasan AhmadDepartment of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Bryan KluckLehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA.
Lehigh Valley Hospital-Pocono · USWestchester Medical Center · USUniversity of Iowa · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEffective platelet inhibition prior to elective percutaneous coronary intervention (PCI) reduces the risk of ischemic complications. Newer P2Y12 inhibitors are preferred agents over clopidogrel for patients presenting with the acute coronary syndrome. However, the comparative efficacy and safety of them over clopidogrel in elective PCI is unclear. We performed a network meta-analysis to compare the safety and efficacy of loading strategies of P2Y12 inhibitors in patients undergoing elective PCI.

methodsWe conducted a systematic review of randomized controlled trials (RCT) up to June 2021 to compare the safety and effectiveness of different loading strategies of P2Y12 inhibitors before elective PCI. The endpoints of interest were overall mortality, rates of myocardial infarction (MI), stroke, revascularization, and major bleeding. Random effects model using the frequentist approach was used to perform a network meta-analysis using R software.

resultsFive trials with a total of 5194 patients were included in our analysis. For ischemic outcomes, including MI, stroke, and revascularization, prasugrel had the most favorable trend. However, clopidogrel had the highest probability of being most effective for major bleeding and all-cause mortality. None of these trends was statistically significant due to lack of power for each outcome.

conclusionAlthough prasugrel and ticagrelor are known as more potent antiplatelet agents, their effects in preventing MI and stroke are marginal and do not translate into improved overall mortality and bleeding compared with clopidogrel.

Indexed as

Myocardial InfarctionPercutaneous Coronary InterventionStrokeClopidogrelHemorrhageHumansPrasugrel HydrochloridePurinergic P2Y Receptor AntagonistsClopidogrelPrasugrel HydrochloridePurinergic P2Y Receptor AntagonistsElective PCILoading doseNetwork meta-analysisP2Y12 inhibitionPercutaneous coronary intervention

Identifiers

PMID34643836
OpenAlexW3205237855

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.