High on‐treatment platelet reactivity with ticagrelor versus prasugrel: a systematic review and meta‐analysis. (21st April 2015) - Lemesle, G.
Summary Background Ticagrelor and prasugrel have shown superiority over clopidogrel. However, it remains unclear if one is superior to another regarding on‐treatment platelet reactivity. Objectives To compare the impact of ticagrelor and prasugrel on high on‐treatment platelet reactivity (HTPR). Methods The PubMed and Cochrane databases were searched for eligible studies in December 2014. Studies were eligible if they compared ticagrelor and prasugrel regarding high on‐treatment platelet reactivity (HTPR). Pooled estimates were calculated by using a random‐effects model with 95% confidence intervals. Results We included 14 studies and 1822 patients: 805 and 1017 in the ticagrelor and prasugrel groups, respectively. The rate of HTPR was significantly lower in the ticagrelor group: 1.5% vs. 9.8% (RR = 0.27 [0.14–0.50]). The pre‐specified analysis focusing on randomized trials (n = 10) showed consistent results (RR = 0.27 [0.12–0.60]). Conclusion Our results suggest that ticagrelor allows a higher platelet reactivity inhibition as compared with prasugrel and leads to a further decrease in the rate of HTPR.