ReviewCureus2025
Efficacy and Safety of Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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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.
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0 citing papers in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Dual antiplatelet therapy (DAPT) is essential post-percutaneous coronary intervention (PCI), yet the optimal P2Y₁₂ inhibitor for chronic coronary syndrome (CCS) remains debated. While ticagrelor demonstrates superior efficacy in acute coronary syndromes (ACS), its role in CCS is unclear. This systematic review and meta-analysis compared ticagrelor versus clopidogrel in CCS patients undergoing PCI. We searched PubMed, Embase, Web of Science, and Cochrane CENTRAL from inception to May 2025. Five studies (two randomized controlled trials (RCTs) and three observational) comprising 32,152 patients were included. Though ticagrelor showed lower all-cause mortality compared to clopidogrel (0.99% vs. 1.26%; RR 0.76, 95% CI: 0.57-1.01), this difference was not statistically significant. Similarly, no significant differences were observed in major adverse cardiovascular events (MACE) (6.23% vs. 6.48%; RR 0.90, 95% CI: 0.70-1.15) or myocardial infarction (MI) (2.67% vs. 1.43%; RR 1.17, 95% CI: 0.94-1.44). Revascularization rates were numerically lower with ticagrelor (3.66% vs. 4.82%; RR 0.83, 95% CI: 0.68-1.01) but not significantly. Notably, ticagrelor significantly reduced stent thrombosis (RR 0.50, 95% CI: 0.26-0.97) without statistically significant increases in minor bleeding (RR 1.66, 95% CI: 0.97-2.85) or major bleeding (RR 1.28, 95% CI: 0.87-1.89). These findings suggest ticagrelor may offer advantages in preventing stent thrombosis but without significant differences in mortality, MACE, or MI compared to clopidogrel in CCS patients. While bleeding risk appears numerically higher with ticagrelor, differences were not statistically significant. Given limited high-quality data specifically for CCS patients, individualized antiplatelet selection balancing thrombotic and bleeding risks remains crucial, with larger RCTs needed to confirm these findings.
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