For Ticagrelor With Clopidogrel Treatment Of Acute Coronary Syndrome Curative Effect And Safety Of Meta Analysis

Objective:Clinical cardiovascular disease is one of the most common and most severe disease of acute coronary syndrome(acutecoronary syndrome ACS),Platelet aggregation was observed and indicators for the treatment of coronary heart disease clinical effect is very important.Clopidogrel(clopidogrel) combined with aspirin treatment is currently the "gold standard" of treatment of acute coronary syndrome.But due to problems of CYP2C19 gene polymorphisms, cause a part of the patient will send in clopidogrel resistance or reaction to it is too low, thereby affect the treatment effect. In many clinical cardiologists were to further improve the effect of drug treatment of ACS patients, looking for a new kind of antiplatelet agents or combination scheme has become one of the immediate task. For Greg los(ticagrelor) direct effects on 12 P2 Y receptors, so without metabolic activation, so as to have faster, stronger and more consistent inhibition of platelet aggregation, and so can significantly reduce the cardiovascular mortality. On behalf of Greg has been listed in China, some hospitals have been applied to clinical.But because there is no systematic evaluation for Greg and clopidogrel between evidence-based medical evidence, the purpose of this study was conducted in the efficacy and safety of the two drugs system evaluation, and to obtain for Greg and clopidogrel treatment in patients with acute coronary syndrome in China effective evidence of efficacy and safety.Methods:Computer retrieval Puh Med, the Cochrane Central Register of Controlled Trials, China hownet(CNKI), VIP medical information resource system(VIP), the data medical information of ten thousand mirror system and read show academic search image database retrieval,Collected from January 2007 to January 2007 published about for Greg lowe and clopidogrel treatment of acute coronary syndrome efficacy and safety comparison of randomized controlled trials(RCTs), at the same time complementary with Shou Jian into literature references. After strict quality of literature evaluation, meets the requirements of data RCTs are extracted, using Rev Men5.2 Meta analysis software.Results:A total of into 25 items RCTs, Meta analysis showed that: for Greg los with clopidogrel group between the incidence of major adverse cardiac events(MACE)(OR = 0.79, 95% confidence interal(0.74, 0.74), P < 0.001) difference was statistically significant. And incidence of myocardial infarction(OR = 0.91, 95% confidence interal(0.81, 0.81), P = 0.117), the incidence of stroke(OR = 1.14, 95% confidence interal(0.88, 0.88), P < 0.314), the incidence of bleeding(OR = 1.00, 95% confidence interal(0.88, 0.88), P = 0.955) had no statistical difference, But the incidence of dyspnea(OR = 1.88, 95% confidence interal(1.71, 1.71), P < 0.001), statistically significant.The platelet inhibition rate(OR = 1.73, 95% confidence interal(1.09, 1.09), P < 0.001) difference have statistical significance.Conclusion:In the treatment of ACS, on behalf of Greg, although significantly higher than that of clopidogrel on the incidence of difficulty in breathing, but the incidence of MACE, myocardial infarction, stroke, bleeding in similar to clopidogrel. On the platelet inhibition rate for Greg los than chlorine pyrrole ray has obvious advantages, for Greg lowe has the potential of alternative to clopidogrel, especially for intolerance to clopidogrel and patients with clopidogrel resistance.