Evidence mapPaperPMID 39654024Full record

SynthesisBMC pharmacology & toxicology2024

A comparison of the effects of ticagrelor and clopidogrel in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials.

Mehdi Geravandi, Mohammad Nourabi, Sepehr Navabifar, Moein Geravandi, Zahra Hooshanginezhad, Sara Zand, Parinaz Taheri

Abstract readMeta-AnalysisSystematic ReviewComparative Study
In one paragraph

Synthesis in BMC pharmacology & toxicology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Reperfusion injury in STEMI: a double-edged sword.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mehdi GeravandiCardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Mohammad NourabiDepartment of Neurology, Faculty of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran.
Sepehr NavabifarCardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Moein GeravandiImam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Zahra HooshanginezhadDepartment of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran.
Sara ZandDepartment of Cardiology, Noor shahriar hospital, Tehran, Iran.
Parinaz TaheriDepartment of Cardiology, Salim Clinic, Tehran, Iran. taheriparinazmd@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRupture of unstable coronary atherosclerotic plaque leads to acute ST-segment elevation myocardial infarction (STEMI). Dual anti-platelet therapy is one of the main treatments, and the combination of Aspirin and Clopidogrel is recognized as the standard oral regimen in most cases. Ticagrelor is a new generation of P2Y12 receptor inhibitors. We aimed to compare the effect of Ticagrelor and Clopidogrel in the treatment of patients post-STEMI.

methodsThis study investigated Pub Med, Scopus, Google Scholar Web of Science, and Embase Cochrane Library clinical trials.gov databases. Heterogeneity between studies was assessed using the I2 index and the Q statistic. The random effects model was used to combine studies and the Funnel plot and Egger's test were used to assess the publication bias.

resultsEleven studies were included in this meta-analysis. 5274 patients in the Ticagrelor and 5,295 patients in the Clopidogrel groups were examined. The mean age of the patients was 58.84 years (2.70) and 59.92 years (3.19) in the Ticagrelor and Clopidogrel groups, respectively. Based on the results of the meta-analysis, compared to Clopidogrel, Ticagrelor had decreased the outcomes of mortality, recurrent myocardial infarction, stroke, and Major Adverse Cardiovascular Events (MACE). However, the post-myocardial infarction bleeding according to Bleeding Academic Research Consortium (BARC) criteria and reperfusion state regarding thrombolysis in myocardial infarction (TIMI) Flow Grading system showed no differences in both groups. However, these effects were not statistically significant.

conclusionsTicagrelor decreased the chance of mortality, re-infarction, stroke, and MACE in post-STEMI patients compared to clopidogrel. But there was no difference in the chance of major bleedings (BARC ≥ 3) and improvement in TIMI grade flow between these two drugs. However, none of these findings were statistically significant, and more studies are needed to reach definitive results.

Indexed as

ClopidogrelPlatelet Aggregation InhibitorsST Elevation Myocardial InfarctionTicagrelorHemorrhageHumansMiddle AgedPurinergic P2Y Receptor AntagonistsRandomized Controlled Trials as TopicClopidogrelPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsTicagrelorAcute coronary syndromeAnti-plateletClopidogrelTicagrelor

Identifiers

PMID39654024
PMCPMC11626762

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.