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首页> 外文期刊>The American Journal of Cardiology >Meta-Analysis of Intraocular Bleeding With Dual Antiplatelet Therapy Using P2Y12 Inhibitors Prasugrel or Ticagrelor
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Meta-Analysis of Intraocular Bleeding With Dual Antiplatelet Therapy Using P2Y12 Inhibitors Prasugrel or Ticagrelor

机译：使用P2Y12抑制剂的双抗血小板治疗普拉布雷或TiCagreloLoR的荟萃分析

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Intraocular bleeding is a devastating clinical event due to its potentially blinding nature. It is not known if determine if dual antiplatelet therapy using aspirin and potent P2Y12 inhibitors increases this risk. We searched MEDLINE and ClinicalTrials.gov for randomized controlled trials that were phase III, randomly assigned patients to dual antiplatelet therapy with either aspirin and a potent P2Y12 inhibitor or aspirin and clopidogrel, had follow-up of 6 months, and at least 200 patients. Corresponding authors were contacted for intraocular bleeding data. Inverse-variance, weighted, fixed-effects meta-analysis was undertaken, with random-effects meta-analysis performed as a sensitivity analysis. Four trials enrolling 42,850 patients were included. The median follow-up ranged from 12 to 14 months. There was overall low risk of bias. Pooled analysis demonstrated no statistically significant increase in the risk of intraocular bleeding with dual antiplatelet therapy using potent P2Y12 inhibitors compared with clopidogrel (risk ratio 0.89, 95% confidence interval 0.58 to 136). There was no significant heterogeneity observed across trials (I-2 statistic 0%, p = 0.98). The use of random-effects meta-analysis did not change the effect estimate or confidence intervals, and the results appeared similar when stratified by potent P2Y12 inhibitor (p = 0.97). In conclusion, this collaborative meta-analysis of dual antiplatelet trials does not suggest that the risk of intraocular bleeding is increased with the use of potent P2Y12 inhibitors compared with clopidogrel. Our results suggest that these potent P2Y12 inhibitors may continue to be used cautiously where indicated as part of dual antiplatelet therapy, even in those at high risk of spontaneous intraocular bleeding. Crown Copyright (C) 2020 Published by Elsevier Inc. All rights reserved.
机译：由于其潜在的致盲性，眼内出血是一种毁灭性的临床活动。如果使用Aspirin和有效的P2Y12抑制剂的双重抗血小板治疗，则不知道是否确定了这种风险。我们搜索了Medline和Clinicaltrials.gov，用于随机对照试验，随机分配给Aspirin和有效的P2Y12抑制剂或阿司匹林和氯吡格雷的双重抗血小板治疗患者，具有6个月的随访，至少200名患者。接触相应的作者进行眼内出血数据。对逆差，加权，固定效应元分析进行，随机效应Meta分析作为灵敏度分析进行。注册42,850名患者的四次试验包括在内。中位后续行动范围从12到14个月。偏见的总体风险很低。汇总分析表明，使用有效的P2Y12抑制剂与氯吡格雷（风险比0.89,95％置信区间0.58至136）相比，使用有效的P2Y12抑制剂与双抗血小板治疗有统计学性的显着增加。在试验中没有显着的异质性（I-2统计0％，p = 0.98）。随机效应元分析的使用没有改变效果估计或置信区间，并且当有效的P2Y12抑制剂（P = 0.97）分层时，结果出现了相似的结果。总之，这种协作的双抗血小板试验的荟萃分析并不表明，与氯吡格雷相比，使用有效的P2Y12抑制剂的使用增加了眼内出血的风险。我们的研究结果表明，这些有效的P2Y12抑制剂可以致命地持续使用，其中甚至在所述双抗血小板治疗的一部分中表明，即使在自发性眼内出血的高风险中也是如此。 Crown版权所有（c）2020由elsevier公司发布的所有权利保留。

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