대한약국학회

Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is the standard of therapy in patients with acute coronary syndrome (ACS). Ticagrelor is a newer oral P2Y12 inhibitor with favorable efficacy and safety outcomes. However, as there are limited and inconsistent findings on the use of ticagrelor compared to clopidogrel in East Asian patients with ACS, we aimed to evaluate the efficacy and safety of ticagrelor compared to clopidogrel by evaluating previous studies conducted in East Asians. A systematic search on studies comparing ticagrelor to clopidogrel in East Asian ACS patients was performed through PubMed, Embase, and Cochrane library by two independent reviewers. A total of 10 studies were included in the meta-analysis. Ticagrelor as compared with clopidogrel significantly reduced the rate of myocardial infarction, stroke, or cardiovascular death in our meta-analysis of the efficacy endpoint. For major bleeding, no significant differences were observed between the two groups. However, for minor bleeding, ticagrelor had significantly increased incidence compared to clopidogrel. In conclusion, in East Asian patients with ACS, ticagrelor can be used with better efficacy and similar incidence of major bleeding compared to clopidogrel, but minor bleeding occurred more frequently.