Sávio Batista, Raphael Camerotte, Agostinho C Pinheiro, Igor Costermani, Anthony Bishay, José Alberto Almeida Filho, Lucca B Palavani, Edmundo Damiani Bertoli, Raphael Bertani, Jason A Ellis, Yafell Serulle, Christian Ferreira
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However, there are few studies assessing the safety of the association of ticagrelor or prasugrel plus aspirin.</p><p><strong>Objectives: </strong>Compare the safety of newer P2Y12 inhibitors with clopidogrel in patients that underwent a SACE for cerebral aneurysms.</p><p><strong>Methods: </strong>In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched PubMed and Embase for studies comparing newer P2Y12 inhibitors with clopidogrel in patients undergoing DAPT for SACE. Outcomes were total number of complications, number of hemorrhagic complications, and number of thromboembolic complications both intraoperative and follow-up. A random effects model was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>We included 1026 patients from six studies. Newer P2Y12 inhibitors were used in 562 (54,77%) patients. There were no significant differences between groups in total number of complications (OR 0.80; 95% CI 0.32, 1.99; <i>p</i> < 0.01; I<sup>2</sup> = 78%), in intraoperative hemorrhagic complications (OR 0.66; 95% CI 0.09, 4.71; <i>p</i> = 0.68; I<sup>2</sup> = 0%), follow-up hemorrhagic complications (OR 1.23; 95% CI 0.70, 2.15; <i>p</i> = 0.49; I<sup>2</sup> = 0%), intraoperative thromboembolic complications (OR 0.43; 95% CI 0.14, 1.35; <i>p</i> = 0.25; I<sup>2</sup> = 24%), and in follow-up thromboembolic complications (OR 0.89; 95% CI 0.33, 2.39; <i>p</i> = 0.03; I<sup>2</sup> = 59%).</p><p><strong>Conclusion: </strong>In patients who underwent a SACE, newer P2Y12 inhibitors showed no differences in intraoperative and follow-up complications compared with clopidogrel.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clopidogrel versus newer P2Y12 inhibitors in the dual antiplatelet therapy for stent-assisted coil embolization of intracranial aneurysms: A meta-analysis.\",\"authors\":\"Sávio Batista, Raphael Camerotte, Agostinho C Pinheiro, Igor Costermani, Anthony Bishay, José Alberto Almeida Filho, Lucca B Palavani, Edmundo Damiani Bertoli, Raphael Bertani, Jason A Ellis, Yafell Serulle, Christian Ferreira\",\"doi\":\"10.1177/15910199241236821\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Stent-assisted coil embolization (SACE) for cerebral aneurysms requires dual antiplatelet therapy (DAPT), commonly clopidogrel plus aspirin is preferable to ticagrelor or prasugrel plus aspirin. 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There were no significant differences between groups in total number of complications (OR 0.80; 95% CI 0.32, 1.99; <i>p</i> < 0.01; I<sup>2</sup> = 78%), in intraoperative hemorrhagic complications (OR 0.66; 95% CI 0.09, 4.71; <i>p</i> = 0.68; I<sup>2</sup> = 0%), follow-up hemorrhagic complications (OR 1.23; 95% CI 0.70, 2.15; <i>p</i> = 0.49; I<sup>2</sup> = 0%), intraoperative thromboembolic complications (OR 0.43; 95% CI 0.14, 1.35; <i>p</i> = 0.25; I<sup>2</sup> = 24%), and in follow-up thromboembolic complications (OR 0.89; 95% CI 0.33, 2.39; <i>p</i> = 0.03; I<sup>2</sup> = 59%).</p><p><strong>Conclusion: </strong>In patients who underwent a SACE, newer P2Y12 inhibitors showed no differences in intraoperative and follow-up complications compared with clopidogrel.</p>\",\"PeriodicalId\":49174,\"journal\":{\"name\":\"Interventional Neuroradiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-03-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Interventional Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/15910199241236821\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15910199241236821","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言：脑动脉瘤支架辅助线圈栓塞术（SACE）需要双联抗血小板疗法（DAPT），通常氯吡格雷加阿司匹林优于替卡格雷或普拉格雷加阿司匹林。然而，很少有研究评估替卡格雷或普拉格雷联合阿司匹林的安全性：比较新型 P2Y12 抑制剂与氯吡格雷在因脑动脉瘤接受 SACE 患者中的安全性：根据《系统综述和荟萃分析首选报告项目》指南，我们在PubMed和Embase上搜索了在接受DAPT治疗的SACE患者中比较新型P2Y12抑制剂和氯吡格雷的研究。研究结果包括术中和随访并发症总数、出血并发症总数以及血栓栓塞并发症总数。采用随机效应模型计算几率比（ORs）及95%置信区间（CIs）：结果：我们纳入了六项研究中的 1026 例患者。562例（54.77%）患者使用了较新的P2Y12抑制剂。在并发症总数（OR 0.80; 95% CI 0.32, 1.99; p 2 = 78%）、术中出血并发症（OR 0.66; 95% CI 0.09, 4.71; p = 0.68; I2 = 0%）、随访出血并发症（OR 1.23；95% CI 0.70，2.15；P = 0.49；I2 = 0%）、术中血栓栓塞并发症（OR 0.43；95% CI 0.14，1.35；P = 0.25；I2 = 24%）和随访血栓栓塞并发症（OR 0.89；95% CI 0.33，2.39；P = 0.03；I2 = 59%）：结论：在接受 SACE 的患者中，较新的 P2Y12 抑制剂与氯吡格雷相比，在术中和随访并发症方面没有差异。
Clopidogrel versus newer P2Y12 inhibitors in the dual antiplatelet therapy for stent-assisted coil embolization of intracranial aneurysms: A meta-analysis.
Introduction: Stent-assisted coil embolization (SACE) for cerebral aneurysms requires dual antiplatelet therapy (DAPT), commonly clopidogrel plus aspirin is preferable to ticagrelor or prasugrel plus aspirin. However, there are few studies assessing the safety of the association of ticagrelor or prasugrel plus aspirin.
Objectives: Compare the safety of newer P2Y12 inhibitors with clopidogrel in patients that underwent a SACE for cerebral aneurysms.
Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched PubMed and Embase for studies comparing newer P2Y12 inhibitors with clopidogrel in patients undergoing DAPT for SACE. Outcomes were total number of complications, number of hemorrhagic complications, and number of thromboembolic complications both intraoperative and follow-up. A random effects model was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs).
Results: We included 1026 patients from six studies. Newer P2Y12 inhibitors were used in 562 (54,77%) patients. There were no significant differences between groups in total number of complications (OR 0.80; 95% CI 0.32, 1.99; p < 0.01; I2 = 78%), in intraoperative hemorrhagic complications (OR 0.66; 95% CI 0.09, 4.71; p = 0.68; I2 = 0%), follow-up hemorrhagic complications (OR 1.23; 95% CI 0.70, 2.15; p = 0.49; I2 = 0%), intraoperative thromboembolic complications (OR 0.43; 95% CI 0.14, 1.35; p = 0.25; I2 = 24%), and in follow-up thromboembolic complications (OR 0.89; 95% CI 0.33, 2.39; p = 0.03; I2 = 59%).
Conclusion: In patients who underwent a SACE, newer P2Y12 inhibitors showed no differences in intraoperative and follow-up complications compared with clopidogrel.
期刊介绍：
Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...
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