Meta-Analysis Comparing the Safety and Efficacy of Prasugrel and Ticagrelor in Acute Coronary Syndrome

Abstract Prasugrel and ticagrelor are preferred over clopidogrel for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We sought to determine the relative merits of one agent over the other. Multiple databases were queried to identify relevant randomized control trials (RCTs) and observational cohort studies (OCS). Random-effects model was used to calculate an unadjusted odds ratio (OR) for major cardiovascular events (MACE) and its components. A total of 27 (7 RCTs, 20 OCS) studies comprising 118,266 (prasugrel 62,716, ticagrelor 51,196) patients were included. At 30-days, prasugrel was associated with a significantly lower odds of MACCE (OR 0.75, 95% confidence interval (CI) 0.67-0.85, p=