PMID- 30456635
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 10
IP  - 1
DP  - 2019 Feb
TI  - Ticagrelor Versus Prasugrel for the Treatment of Patients with Type 2 Diabetes 
      Mellitus Following Percutaneous Coronary Intervention: A Systematic Review and 
      Meta-Analysis.
PG  - 81-93
LID - 10.1007/s13300-018-0537-7 [doi]
AB  - INTRODUCTION: Antiplatelet therapy is very important following percutaneous 
      coronary intervention (PCI). New generation P2Y(12) inhibitors (ticagrelor and 
      prasugrel) might potentially replace clopidogrel for the treatment of 
      post-interventional acute coronary syndrome (ACS). In this analysis, we aimed to 
      systematically compare the post-interventional clinical outcomes and bleeding 
      events observed with ticagrelor versus prasugrel in patients with type 2 diabetes 
      mellitus (T2DM). METHODS: EMBASE, MEDLINE, the Cochrane Central Register of 
      Controlled Trials, and www.ClinicalTrials.gov were carefully searched for 
      publications comparing the post-coronary interventional outcomes following 
      ticagrelor versus prasugrel use in patients with T2DM. Adverse clinical outcomes 
      and bleeding events were considered as the endpoints. Statistical analysis was 
      carried out by the Revman software (version 5.3). Odds ratios (OR) and 95% 
      confidence intervals (CI) were used to represent the data during subgroup 
      analysis. RESULTS: A total of 2004 participants with T2DM were included in this 
      analysis. Following PCI, mortality (OR 1.00, 95% CI 0.57-1.76; P = 0.99, 
      I(2) = 19%), myocardial infarction (OR 0.86, 95% CI 0.42-1.75; P = 0.67, 
      I(2) = 0%), major adverse cardiac events (OR 0.73, 95% CI 0.42-1.27; P = 0.27, 
      I(2) = 0%), and stroke (OR 0.72, 95% CI 0.20-2.59; P = 0.61, I(2) = 0%) were not 
      significantly different between ticagrelor and prasugrel. In addition, total 
      bleeding events (OR 0.87, 95% CI 0.55-1.40; P = 0.58, I(2) = 6%), Thrombolysis in 
      Myocardial Infarction (TIMI) defined minor bleeding (OR 2.39, 95% CI 0.58-9.91; 
      P = 0.23, I(2) = 0%), TIMI defined major bleeding (OR 1.42, 95% CI 0.27-7.45; 
      P = 0.68, I(2) = 0%), bleeding defined according to the Bleeding Academic 
      Research Consortium (BARC) major bleeding (OR 0.55, 95% CI 0.22-1.36; P = 0.20, 
      I(2) = 0%), BARC minor bleeding (OR 1.44, 95% CI 0.52-3.99; P = 0.48, I(2) = 0%), 
      and total minimal bleeding (OR 3.12, 95% CI 0.55-17.59; P = 0.20, I(2) = 0%) were 
      also not significantly different. CONCLUSION: Ticagrelor and prasugrel were not 
      associated with significantly different adverse clinical outcomes and bleeding 
      events in these patients with T2DM. Therefore, both antiplatelet agents might 
      safely be used in patients with T2DM following coronary intervention. However, 
      this head-to-head comparison still remains a major challenge which should be 
      resolved in larger clinical trials.
FAU - Yang, Hua
AU  - Yang H
AD  - Department of Cardiology, Jingzhou Central Hospital, The Second Clinical Medical 
      College, Yangtze University, Jingzhou, 434020, Hubei, China. 18107168135@163.com.
FAU - Tang, Bing
AU  - Tang B
AD  - Department of Cardiology, Jingzhou Central Hospital, The Second Clinical Medical 
      College, Yangtze University, Jingzhou, 434020, Hubei, China.
FAU - Xu, Chen Hong
AU  - Xu CH
AD  - Department of Cardiology, Jingzhou Central Hospital, The Second Clinical Medical 
      College, Yangtze University, Jingzhou, 434020, Hubei, China.
FAU - Ahmed, Anis
AU  - Ahmed A
AD  - Department of Internal Medicine, Ealing Hospital, University of Buckingham, 
      London, UK.
LA  - eng
PT  - Journal Article
DEP - 20181119
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC6349280
OTO - NOTNLM
OT  - Bleeding events
OT  - Clinical outcomes
OT  - Percutaneous coronary intervention
OT  - Prasugrel
OT  - Ticagrelor
OT  - Type 2 diabetes mellitus
EDAT- 2018/11/21 06:00
MHDA- 2018/11/21 06:01
PMCR- 2018/11/19
CRDT- 2018/11/21 06:00
PHST- 2018/10/23 00:00 [received]
PHST- 2018/11/21 06:00 [pubmed]
PHST- 2018/11/21 06:01 [medline]
PHST- 2018/11/21 06:00 [entrez]
PHST- 2018/11/19 00:00 [pmc-release]
AID - 10.1007/s13300-018-0537-7 [pii]
AID - 537 [pii]
AID - 10.1007/s13300-018-0537-7 [doi]
PST - ppublish
SO  - Diabetes Ther. 2019 Feb;10(1):81-93. doi: 10.1007/s13300-018-0537-7. Epub 2018 
      Nov 19.