Efficacy and safety of ticagrelor versus aspirin and clopidogrel for stroke prevention in patients with vascular disease: a systematic review and meta-analysis

Introduction: Currently, it is still controversial to treat stroke with ticagrelor alone. The purpose of our study was to systematically review and analyze the efficacy and safety of ticagrelor on cerebrovascular outcomes in patients with vascular risk factors. Methods: The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords stroke, ticagrelor, clopidogrel, and aspirin to identify randomized controlled trials (RCT). Primary outcomes included reported stroke, ischemic stroke and complex events; the secondary outcome was hemorrhagic stroke. The safety outcomes included major bleeding events, major or minor bleeding, and intracranial bleeding. The pooled odds ratio (OR), hazard ratios (HR), and 95% confidence interval (CI) were calculated.And we used I2 statistics to assess statistical heterogeneity. Results: This meta-analysis included 15 RCTs involving 63,865 patients. Compared to the control group, ticagrelor reduced the risk of stroke (OR: 0.90; 95%CI:0.81 –0.99, p = 0.03; I² = 3%), ischemic stroke (OR:0.81; 95%CI: 0.74-0.90; p
Source: European Neurology - Category: Neurology Source Type: research