ABSTRACT Objective:To support clinical practice and decision making by evaluating the efficacy, safety and economic efficiency of new platelet inhibition regimens targeting P2Y12 receptors ticagrelor in patients with acute coronary syndrome (ACS). Methods: Database such as PubMed, Embase, the Cochrane Library, Web of Science, CNKI and SinoMed were searched to collect HTA reports, systematic reviews/meta analyses, RCTs and pharmacoeconomic studies. Results:In regard to efficacy outcomes, compared with clopidogrel, ticagrelor reduced the incidence of major adverse cardiovascular events (RR=0.86,95%CI:0.79 0.94,P=0.000 4), cardiovascular deaths (RR=0.77,95%CI:0.68 0.88,P<0.000 1), all cause mortality (RR=0.81,95%CI:0.71 0.91,P=0.000 8), myocardial infarction (RR=0.82,95%CI:0.73 0.91,P=0.000 2), stent thrombosis (RR=0.74,95%CI:0.61 0.91,P=0.004). In regard to safety outcomes, ticagrelor didn’t increase the incidence of major bleeding (RR=1.04,95%CI:0.96 1.13,P=0.30) and bradycardia (RR=1.12,95%CI:0.98 1.28,P=0.08), while it increased the incidence of major/minor bleeding (RR=1.28,95%CI:1.04 1.58,P=0.02) and dyspnea (RR=1.76,95%CI:1.62 1.91,P<0.000 01). In regard to economic efficiency, ticagrelor was cost effectiveness compared to clopidogrel and genotype driven antiplatelet therapy.Conclusion:Ticagrelor had favorable profiles in efficacy, safety and economical efficiency in the treatment of ACS. |