PMID- 38439698
OWN - NLM
STAT- Publisher
LR  - 20240305
IS  - 2385-2011 (Electronic)
IS  - 1591-0199 (Linking)
DP  - 2024 Mar 5
TI  - Clopidogrel versus newer P2Y12 inhibitors in the dual antiplatelet therapy for 
      stent-assisted coil embolization of intracranial aneurysms: A meta-analysis.
PG  - 15910199241236821
LID - 10.1177/15910199241236821 [doi]
AB  - INTRODUCTION: Stent-assisted coil embolization (SACE) for cerebral aneurysms 
      requires dual antiplatelet therapy (DAPT), commonly clopidogrel plus aspirin is 
      preferable to ticagrelor or prasugrel plus aspirin. However, there are few 
      studies assessing the safety of the association of ticagrelor or prasugrel plus 
      aspirin. OBJECTIVES: Compare the safety of newer P2Y12 inhibitors with 
      clopidogrel in patients that underwent a SACE for cerebral aneurysms. METHODS: In 
      accordance with the Preferred Reporting Items for Systematic Reviews and 
      Meta-Analysis guidelines, we searched PubMed and Embase for studies comparing 
      newer P2Y12 inhibitors with clopidogrel in patients undergoing DAPT for SACE. 
      Outcomes were total number of complications, number of hemorrhagic complications, 
      and number of thromboembolic complications both intraoperative and follow-up. A 
      random effects model was used to calculate odds ratios (ORs) with 95% confidence 
      intervals (CIs). RESULTS: We included 1026 patients from six studies. Newer P2Y12 
      inhibitors were used in 562 (54,77%) patients. There were no significant 
      differences between groups in total number of complications (OR 0.80; 95% CI 
      0.32, 1.99; p < 0.01; I(2) = 78%), in intraoperative hemorrhagic complications 
      (OR 0.66; 95% CI 0.09, 4.71; p = 0.68; I(2) = 0%), follow-up hemorrhagic 
      complications (OR 1.23; 95% CI 0.70, 2.15; p = 0.49; I(2) = 0%), intraoperative 
      thromboembolic complications (OR 0.43; 95% CI 0.14, 1.35; p = 0.25; I(2) = 24%), 
      and in follow-up thromboembolic complications (OR 0.89; 95% CI 0.33, 2.39; 
      p = 0.03; I(2) = 59%). CONCLUSION: In patients who underwent a SACE, newer P2Y12 
      inhibitors showed no differences in intraoperative and follow-up complications 
      compared with clopidogrel.
FAU - Batista, Savio
AU  - Batista S
AD  - Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 
      Brazil. RINGGOLD: 28125
FAU - Camerotte, Raphael
AU  - Camerotte R
AD  - Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 
      Brazil. RINGGOLD: 28125
FAU - Pinheiro, Agostinho C
AU  - Pinheiro AC
AUID- ORCID: 0000-0002-2496-9479
AD  - Department of Internal Medicine, Elmhurst Hospital Center, Icahn School of 
      Medicine at Mount Sinais, New York, NY, USA.
AD  - Department of Neurology, Massachusetts General Hospital, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Costermani, Igor
AU  - Costermani I
AD  - Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 
      Brazil. RINGGOLD: 28125
FAU - Bishay, Anthony
AU  - Bishay A
AD  - Department of Internal Medicine, Elmhurst Hospital Center, Icahn School of 
      Medicine at Mount Sinais, New York, NY, USA.
FAU - Almeida Filho, Jose Alberto
AU  - Almeida Filho JA
AD  - Department of Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, 
      Rio de Janeiro, RJ, Brazil.
FAU - Palavani, Lucca B
AU  - Palavani LB
AD  - Faculty of Medicine, Max Planck University Center, Indaiatuba, SP, Brazil.
FAU - Bertoli, Edmundo Damiani
AU  - Bertoli ED
AUID- ORCID: 0009-0008-8734-3802
AD  - Faculty of Medicine, Cidade Universitaria, Palhoca, SC, Brazil.
FAU - Bertani, Raphael
AU  - Bertani R
AUID- ORCID: 0000-0001-6546-2634
AD  - Department of Neurosurgery, University of Sao Paulo, Sao Paulo, SP, Brazil. 
      RINGGOLD: 168383. RINGGOLD: 28133
FAU - Ellis, Jason A
AU  - Ellis JA
AD  - Department of Neurosurgery, Lenox Hill Hospital, New York, NY, USA. RINGGOLD: 
      5945
FAU - Serulle, Yafell
AU  - Serulle Y
AD  - Department of Neurosurgery, Lenox Hill Hospital, New York, NY, USA. RINGGOLD: 
      5945
FAU - Ferreira, Christian
AU  - Ferreira C
AUID- ORCID: 0009-0001-5325-1343
AD  - Department of Neurosurgery, Lenox Hill Hospital, New York, NY, USA. RINGGOLD: 
      5945
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240305
PL  - United States
TA  - Interv Neuroradiol
JT  - Interventional neuroradiology : journal of peritherapeutic neuroradiology, 
      surgical procedures and related neurosciences
JID - 9602695
SB  - IM
OTO - NOTNLM
OT  - aneurysm
OT  - clopidogrel
OT  - dual anti-platelet therapy
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2024/03/05 06:44
MHDA- 2024/03/05 06:44
CRDT- 2024/03/05 03:23
PHST- 2024/03/05 06:44 [medline]
PHST- 2024/03/05 06:44 [pubmed]
PHST- 2024/03/05 03:23 [entrez]
AID - 10.1177/15910199241236821 [doi]
PST - aheadofprint
SO  - Interv Neuroradiol. 2024 Mar 5:15910199241236821. doi: 10.1177/15910199241236821.