Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Am J Cardiol. 2023 Nov 15:207:206-214. doi: 10.1016/j.amjcard.2023.08.117. Epub 2023 Sep 24.

Abstract

Limited data comparing prasugrel and ticagrelor in acute coronary syndrome are available. Online databases, including MEDLINE and Cochrane Central, were queried to compare these drugs. The primary outcomes of this meta-analysis are myocardial infarction (MI), all-cause mortality, cardiovascular mortality, noncardiovascular mortality, stent thrombosis, and stroke. The secondary outcome is major bleeding. A total of 9 studies, including 94,590 patients (prasugrel group = 32,759; ticagrelor group = 61,831), were included in this meta-analysis. The overall mean age was 62.73 years, whereas the mean age for the ticagrelor and prasugrel groups was 63.80 and 61.65 years, respectively. Prasugrel is equally effective as compared with ticagrelor in preventing MI. There was no difference between the 2 groups regarding all-cause mortality, stent thrombosis, stroke, or major bleeding. In patients with acute coronary syndrome, prasugrel is equally effective when compared with ticagrelor in preventing MI.

Keywords: angioplasty; balloon; coronary artery; myocardial infarction; percutaneous coronary intervention.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Acute Coronary Syndrome* / drug therapy
  • Hemorrhage / chemically induced
  • Humans
  • Middle Aged
  • Myocardial Infarction*
  • Percutaneous Coronary Intervention*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prasugrel Hydrochloride / therapeutic use
  • Purinergic P2Y Receptor Antagonists / therapeutic use
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Thrombosis*
  • Ticagrelor / therapeutic use
  • Treatment Outcome

Substances

  • Ticagrelor
  • Prasugrel Hydrochloride
  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists