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Article: Risk of infections in patients treated with ticagrelor vs. clopidogrel: a systematic review and meta-analysis

TitleRisk of infections in patients treated with ticagrelor vs. clopidogrel: a systematic review and meta-analysis
Authors
KeywordsTicagrelor
Clopidogrel
Pneumonia
Infections
Meta-analysis
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://ehjcvp.oxfordjournals.org/
Citation
European Heart Journal - Cardiovascular Pharmacotherapy, 2021, v. 7 n. 3, p. 171-179 How to Cite?
AbstractAims: Ticagrelor has been shown to reduce the risk of pneumonia and improve lung function, but the findings across studies were inconsistent. The objective is to investigate the relative safety of ticagrelor vs. clopidogrel on infection outcomes in patients with cardiovascular diseases. Methods and results: We searched MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov up to 15 October 2019. Randomized controlled trials comparing ticagrelor and clopidogrel that reported infection outcomes were included. The primary outcome was pneumonia. Secondary outcomes were upper respiratory tract infection (URTI), urinary tract infection (UTI), and sepsis. Study quality was assessed using the Cochrane Risk of Bias tool. Study selection, data extraction, and quality assessment were conducted by independent authors. Random-effects model was used for data synthesis. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled with a random-effects model. Out of 5231 citations, 10 trials with altogether 37 514 patients were included. Ticagrelor was associated with a lower risk of pneumonia (RR 0.80, 95% CI 0.67–0.95) compared to clopidogrel. There were no statistically significant differences for URTI (RR 0.71, 95% CI 0.34–1.48), UTI (RR 1.06, 95% CI 0.73–1.64), or sepsis (RR 0.79, 95% CI 0.50–1.26). Conclusion: Compared to clopidogrel, ticagrelor reduces the risk of pneumonia, but not URTI, UTI, or sepsis. Our study provides further evidence for recommending ticagrelor to patients with acute coronary syndrome at risk of pneumonia, although the mechanism by which ticagrelor reduces the risk of pneumonia merits further research.
Persistent Identifierhttp://hdl.handle.net/10722/290942
ISSN
2021 Impact Factor: 11.177
2020 SCImago Journal Rankings: 1.895
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, HL-
dc.contributor.authorFeng, Q-
dc.contributor.authorTsoi, MF-
dc.contributor.authorFei, Y-
dc.contributor.authorCheung, BMY-
dc.date.accessioned2020-11-02T05:49:17Z-
dc.date.available2020-11-02T05:49:17Z-
dc.date.issued2021-
dc.identifier.citationEuropean Heart Journal - Cardiovascular Pharmacotherapy, 2021, v. 7 n. 3, p. 171-179-
dc.identifier.issn2055-6837-
dc.identifier.urihttp://hdl.handle.net/10722/290942-
dc.description.abstractAims: Ticagrelor has been shown to reduce the risk of pneumonia and improve lung function, but the findings across studies were inconsistent. The objective is to investigate the relative safety of ticagrelor vs. clopidogrel on infection outcomes in patients with cardiovascular diseases. Methods and results: We searched MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov up to 15 October 2019. Randomized controlled trials comparing ticagrelor and clopidogrel that reported infection outcomes were included. The primary outcome was pneumonia. Secondary outcomes were upper respiratory tract infection (URTI), urinary tract infection (UTI), and sepsis. Study quality was assessed using the Cochrane Risk of Bias tool. Study selection, data extraction, and quality assessment were conducted by independent authors. Random-effects model was used for data synthesis. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled with a random-effects model. Out of 5231 citations, 10 trials with altogether 37 514 patients were included. Ticagrelor was associated with a lower risk of pneumonia (RR 0.80, 95% CI 0.67–0.95) compared to clopidogrel. There were no statistically significant differences for URTI (RR 0.71, 95% CI 0.34–1.48), UTI (RR 1.06, 95% CI 0.73–1.64), or sepsis (RR 0.79, 95% CI 0.50–1.26). Conclusion: Compared to clopidogrel, ticagrelor reduces the risk of pneumonia, but not URTI, UTI, or sepsis. Our study provides further evidence for recommending ticagrelor to patients with acute coronary syndrome at risk of pneumonia, although the mechanism by which ticagrelor reduces the risk of pneumonia merits further research.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ehjcvp.oxfordjournals.org/-
dc.relation.ispartofEuropean Heart Journal - Cardiovascular Pharmacotherapy-
dc.rightsThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in European Heart Journal - Cardiovascular Pharmacotherapy following peer review. The definitive publisher-authenticated version European Heart Journal - Cardiovascular Pharmacotherapy, 2021, v. 7 n. 3, p. 171-179 is available online at: https://academic.oup.com/ehjcvp/article-abstract/7/3/171/5860832?redirectedFrom=fulltext-
dc.subjectTicagrelor-
dc.subjectClopidogrel-
dc.subjectPneumonia-
dc.subjectInfections-
dc.subjectMeta-analysis-
dc.titleRisk of infections in patients treated with ticagrelor vs. clopidogrel: a systematic review and meta-analysis-
dc.typeArticle-
dc.identifier.emailFei, Y: fayeyfei@hku.hk-
dc.identifier.emailCheung, BMY: mycheung@hkucc.hku.hk-
dc.identifier.authorityCheung, BMY=rp01321-
dc.description.naturepostprint-
dc.identifier.doi10.1093/ehjcvp/pvaa065-
dc.identifier.pmid32569384-
dc.identifier.scopuseid_2-s2.0-85092362024-
dc.identifier.hkuros318457-
dc.identifier.volume7-
dc.identifier.issue3-
dc.identifier.spage171-
dc.identifier.epage179-
dc.identifier.isiWOS:000659444600032-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl2055-6837-

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