SynthesisMedicine2026
Ticagrelor versus clopidogrel in STEMI post-PCI: A mixed-design meta-analysis of efficacy and safety.
Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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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.
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundST-segment elevation myocardial infarction (STEMI) requires primary percutaneous coronary intervention (PCI) and dual antiplatelet therapy with aspirin and a purinergic receptor Y12 inhibitor to reduce thrombotic risks. Ticagrelor, a potent purinergic receptor Y12 inhibitor, offers faster and stronger platelet inhibition than clopidogrel, but evidence on its efficacy and safety in STEMI patients post-PCI is conflicting. This study aims to compare the efficacy and safety of ticagrelor versus clopidogrel in STEMI patients undergoing primary PCI.
methodsThis systematic review and meta-analysis, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, searched PubMed, Embase, ScienceDirect, and ClinicalTrials.gov up to July 2025. Included were randomized controlled trials and observational studies comparing ticagrelor to clopidogrel in adult STEMI patients post-PCI, reporting cardiovascular outcomes. Data were pooled using odds ratios (ORs) with 95% confidence intervals (CIs) via random-effects models.
resultsEight studies (5 randomized controlled trials, 3 observational; n = 31,729) showed ticagrelor significantly reduced all-cause mortality (OR = 0.64, 95% CI = 0.47-0.88; P = .006), cardiovascular mortality (OR = 0.68, 95% CI = 0.60-0.93; P = .01), major adverse cardiovascular events (OR = 0.71, 95% CI = 0.60-0.84; P = .01), myocardial infarction (OR = 0.71, 95% CI = 0.61-0.83; P < .00001), stent thrombosis (OR = 0.66, 95% CI = 0.55-0.79; P < .00001), and major bleeding (OR = 0.87, 95% CI = 0.78-0.97; P = .01), but increased target vessel revascularization (OR = 1.30, 95% CI = 1.05-1.61; P = .02). No significant difference was observed in stroke risk (OR = 1.16, 95% CI = 0.89-1.52; P = .28).
conclusionTicagrelor outperforms clopidogrel in STEMI post-PCI, reducing key adverse outcomes, though higher target vessel revascularization risk warrants caution.
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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.