Your browser doesn't support javascript.
loading
Ticagrelor versus clopidogrel in dual antiplatelet therapy after minor stroke or transient ischemic attack: an updated network meta-analysis.
Marinheiro, Gabriel; Araújo, Beatriz; Monteiro, Gabriel de Almeida; Leite, Marianna; Mutarelli, Antonio; Almeida, Artur Menegaz de; Cavalcante-Neto, Joaquim Francisco; Rivera, André; Pinheiro, Agostinho C; Telles, João Paulo Mota.
Afiliação
  • Marinheiro G; School of Medicine, Federal University of Ceará, Sobral, Brazil. gabrielmarinheirosb@gmail.com.
  • Araújo B; Department of Medicine, Nove de Julho University, São Bernardo do Campo, Brazil.
  • Monteiro GA; School of Medicine, Federal University of Ceará, Sobral, Brazil.
  • Leite M; School of Medicine, Santa Marcelina College, São Paulo, Brazil.
  • Mutarelli A; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Almeida AM; Federal University of Mato Grosso, Sinop, Brazil.
  • Cavalcante-Neto JF; Department of Neurosurgery, Federal University of Ceará, Sobral, Brazil.
  • Rivera A; Department of Medicine, Nove de Julho University, São Bernardo do Campo, Brazil.
  • Pinheiro AC; Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
  • Telles JPM; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, USA.
J Neurol ; 271(6): 3030-3038, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38580815
ABSTRACT

BACKGROUND:

Dual antiplatelet therapy (DAPT) with clopidogrel plus aspirin is a well-established practice after a minor stroke or transient ischemic attack (TIA). However, ticagrelor plus aspirin may be an alternative.

AIMS:

We systematically searched PubMed, Embase, and Cochrane Central from inception to January 2024. We included randomized controlled trials (RCTs) enrolling adults with acute minor stroke or TIA within 72 hours of the onset of the symptoms.

RESULTS:

A total of 8 RCTs were included in our meta-analysis. Ticagrelor plus aspirin (RR, 0.70; 95% CrI 0.52, 0.91) and clopidogrel plus aspirin (RR, 0.79; 95% CrI 0.64, 0.98) were superior to aspirin in preventing stroke recurrence in overall analysis. Excluding studies with dual antiplatelet up to 90 days, ticagrelor plus aspirin was the only strategy that maintained superiority compared with aspirin regarding stroke recurrence (RR, 0.70; 95% CrI 0.51, 0.95) and ischemic stroke (RR, 0.68; 95% CrI 0.47, 0.94). There was no significant difference between treatment groups regarding hemorrhagic stroke, functional disability, and mortality.

CONCLUSIONS:

DAPTs were superior to aspirin in preventing recurrence or ischemic stroke. Although no significant difference was observed between DAPTs, ticagrelor plus aspirin may be related to worse major bleeding results, including intracranial bleeding. Ticagrelor plus aspirin is a considerable option for patients after a minor stroke or TIA.
Assuntos
Palavras-chave
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Ataque Isquêmico Transitório / Acidente Vascular Cerebral / Metanálise em Rede / Clopidogrel / Ticagrelor / Terapia Antiplaquetária Dupla Limite: Humans Idioma: En Revista: J Neurol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Ataque Isquêmico Transitório / Acidente Vascular Cerebral / Metanálise em Rede / Clopidogrel / Ticagrelor / Terapia Antiplaquetária Dupla Limite: Humans Idioma: En Revista: J Neurol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha