Meta-Analysis of Randomized Controlled Trials Comparing Risk of Major Adverse Cardiac Events and Bleeding in Patients With Prasugrel Versus Clopidogrel
Meta-Analysis of Randomized Controlled Trials Comparing Risk of Major Adverse Cardiac Events and Bleeding in Patients With Prasugrel Versus Clopidogrel
复制标题
比较普拉格雷与氯吡格雷患者主要不良心脏事件和出血风险的随机对照试验的荟萃分析
DOI：
10.1016/j.amjcard.2015.04.054
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发表时间：
2015-08-01
影响因子：
2.8
通讯作者：
Xiu, Jiancheng
中科院分区：
文献类型：
--
作者：
Chen, Hai-Bin;Zhang, Xin-Lu;Xiu, Jiancheng
与氯吡格雷相比，在冠心病（CAD）患者中使用普拉格雷虽可减少主要不良心血管事件（MACE），但出血风险增加。然而，对于使用普拉格雷治疗的患者，出血风险是否超过主要不良心血管事件的风险仍不明确。我们系统回顾了在冠心病患者中比较普拉格雷和氯吡格雷的随机对照试验。我们对PubMed、EMBASE和Cochrane中心对照试验注册库从建库至2014年11月25日进行了文献检索，并查阅了检索到的文章的参考文献列表。在本荟萃分析框架内，对相同试验中的主要不良心血管事件和出血的合并发生率进行了比较估计，并在随机效应和固定效应模型中以比值比（OR）和95%置信区间（CI）表示。我们的荟萃分析纳入了9项研究，涉及25214名患者。在随机效应和固定效应模型中，主要不良心血管事件的风险均超过了主要出血的风险（OR 7.48，95% CI 3.75 - 14.94，p <...（此处原文似乎不完整）
The use of prasugrel in patients with coronary artery disease (CAD) has been associated with decreased major adverse cardiac events (MACEs) compared with clopidogrel but with an increased risk of bleeding. However, it remains unclear if the risks of bleeding outweigh those of MACEs in patients on prasugrel treatment. We systematically reviewed randomized controlled trials comparing prasugrel with clopidogrel in patients with CAD. We performed a literature search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trial databases from inception to November 25, 2014, and reviewed the reference lists of retrieved articles. A comparative estimate was made for the combined rates of MACEs and bleeding from the same trials in the framework of this meta-analysis and expressed as odds ratios (ORs) and 95% confidence intervals (CIs) in both random- and fixed-effects models. Nine studies involving 25,214 patients were included in our meta-analysis. In both the random- and fixed-effects models, the risks of MACEs outweighed those of major bleeding (OR 7.48, 95% CI 3.75 to 14.94, p