Comparison between ticagrelor and clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention: A systematic review and meta-analysis

Clopidogrel and ticagrelor are commonly prescribed medication in acute coronary syndrome patients after they undergo Percutaneous coronary intervention, however, the advantages of these medications are associated with some side effects, a few of which are more debilitating than the others and have serious consequences for the patients. Utilizing online sources, including PubMed, Embase, Cochrane, and Google Scholar, a thorough literature search was conducted. Studies were selected by careful analysis of the inclusion and exclusion criteria. There were discovered to be 9 Randomized controlled trials that qualified. The study was carried out in accordance with the PRISMA recommendations. Ticagrelor was found to have more bleeding events in comparison to clopidogrel (p = 0.01; RR, 1.40; 95% CI, 0.99–1.97; I2 = 0%). Similarly, the major bleeding risk was also high in the ticagrelor group according to the PLATO criteria (p = 0.01; RR, 1.61; 95% CI, 1.21–2.31; I2 = 0%). However, no significant difference was found according to the thrombolysis in myocardial infarction (TIMI) classification (RR, 1.54; 95% CI, 0.62–3.86; I2 = 29%), which was also consistent with our various secondary outcomes. Although our study showed a trend toward more bleeding events with ticagrelor in relation to the overall bleeding risk and PLATO criteria, there were still some confounding factors that needed to be addressed to increase the study's yield. As the field of bleeding events research grows, more thorough studies are needed in the future to draw firm conclusions.