Table 2.
A summary of clinical trials and meta-analyses presenting effects of pretreatment with P2Y12 receptor inhibitors.
| Author/Study | Agent Used in Pretreatment | Condition | Efficacy Outcome | Safety Outcome | Reference | |
|---|---|---|---|---|---|---|
| 1. | Uwe/CIPAMI | clopidogrel | STEMI | ns | ns | [26] |
| 2. | Ducci/Load&Go | clopidogrel | STEMI | ns | ns | [29] |
| 3. | Montalescot/ATLANTIC | ticagrelor | STEMI | ns |
p = 0.008 at 24 h, p = 0.02 at 30 days |
[30] |
| 4. | Sabatine/PCI-CLARITY | clopidogrel | STEMI | p = 0.001 (less CV death, MI, or stroke before and after PCI) | ns | [30] |
| 5. | Dörler/Austrian Registry | clopidogrel | STEMI | Lower rate of in-hospital mortality (p < 0.01) | Risk of bleeding not significantly increased (p = 0.90) | [27] |
| 6. | Koul/SCAAR | clopidogrel | STEMI | 1-year death/MI and 1-year death alone significantly reduced | Bleeding risk—ns | [28] |
| 7. | Schupke/ISAR-REACT 5 | ticagrelor | ACS | Pretreatment associated with worse outcomes; prasugrel (no-pretreatment) better than ticagrelor (pretreatment)—fewer deaths, MI or stroke; p = 0.006—see text | ns | [32] |
| 8. | Montalescot/ACCOAST | prasugrel | NSTE-ACS | Early pretreatment—24% risk reduction (p = 0.004) | CABG-related and non-CABG-related TIMI major bleedings increased at day 7 (p = 0.006) and day 30 (p = 0.002) Early pretreatment—ns (p = 0.23) |
[35] |
| 9. | Dworeck/SCAAR | 43.7% clopidogrel, 54.5% ticagrelor, 1.8% prasugrel | NSTE-ACS | ns | All bleedings: p = 0.02 only major bleeding: p = 0.002 |
[36] |
| 10. | Steinhubl/CREDO | clopidogrel | NSTE-ACS | Fewer deaths, MI, TVR if administered >6 h prior to PCI (p = 0.051) | ns | [37] |
| 11. | Tarantini/DUBIUS | ticagrelor, prasugrel | NSTE-ACS | ns | ns | [38] |
| 12. | Bellemain-Appaix/meta-analysis | clopidogrel, prasugrel | ACS | No reduction in all-cause mortality (p = 0.24) | 30–45% increased risk of bleeding (p < 0.0001) | [39] |
| 13. | Bellemain-Appaix/meta-analysis | clopidogrel | ACS and CCS | Fewer CV episodes (p < 0.001), no reduction in deaths (p = 0.17) | ns | [40] |
| 14. | Nairooz/meta-analysis | clopidogrel | ACS | Fewer MACEs: p < 0.0001 Lower mortality: p = 0.0003 |
ns | [41] |
ACS—acute coronary syndrome, CV—cardiovascular, MACE—major adverse cardiovascular events, MI—myocardial infarction, ns—non-significant, NSTE-ACS—non-ST-elevation acute coronary syndrome, STEMI—ST segment elevation myocardial infarction, TVR—target vessel revascularization.