解放军医学杂志2018，Vol.43Issue(3)：244-250,7.DOI:10.11855/j.issn.0577-7402.2018.03.12
替卡格雷与氯吡格雷治疗急性冠脉综合征安全性的系统评价
Safety of ticagrelor and clopidogrel for acute coronary syndromes: A systemic analysis
胡方圆 1王九生 2杨伟鹏 1曹鹏 1吴多博 1熊林平3
作者信息
- 1. 200433 上海 海军军医大学公共卫生事业管理学员队
- 2. 200003 上海 海军军医大学附属长征医院肾内科、解放军肾脏病研究所
- 3. 200433 上海 海军军医大学卫生勤务学系卫生事业管理学教研室
- 折叠
摘要
Abstract
Objective To systemically evaluate the different on the incidence of cardiovascular events of platelet aggregation inhibitors ticagrelor and clopidogrel for acute coronary syndrome (ACS),so provide cardiovascular event reference for the selection ofACS platelet inhibitors.Methods Articles were collected according to the inclusion criteria from the database CNKI,Chongqing VIP,Taylor & Francis Open Access Journals,Wanfang,Cochrane Library,SinoMed,EMbase and PubMed from Jan.2000 to May 2017.Review Manager 5.3 was used for data analysis to get the odds ratio (OR) as final effect value.Publication bias of the literatures and the sensitivity of the study were also analyzed with the software.Results A total of 12 articles involving 86 849 patients were included,i.e.,8 random controlled trials,2 case control studies and 2 cohort studies.Quality assessment with Cochrane handbook for systematic reviews shows that,most studies gave low risks in 7 bias aspects.Jadad score assessment was employed in 8 random controlled trials,with 4 studies getting 3 points,3 getting 4 points and 1 getting 5 points,implying the significant quality of the included studies.Meta-analysis showed that compared with clopidogrel,significantly lower cardiovascular mortality (OR=0.80,95％CI:0.72-0.89,P＜0.01) and incidence of myocardial infarction (OR=0.78,95％CI:0.61-0.99,P＜0.05)were with ticagrelor.Conclusion Compared to clopidogrel,ticagrelor may lead to lower cardiovascular mortality and incidence of myocardial infarction in treatment of ACS.关键词
急性冠脉综合征/血小板抑制剂/替卡格雷/氯吡格雷/心血管死亡/心肌梗死/Meta分析Key words
acute coronary syndrome/platelet aggregation inhibitors/ticagrelor/clopidogrel/cardiovascular mortality/myocardial infarction/Meta analysis分类
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胡方圆,王九生,杨伟鹏,曹鹏,吴多博,熊林平..替卡格雷与氯吡格雷治疗急性冠脉综合征安全性的系统评价[J].解放军医学杂志,2018,43(3):244-250,7.
