Table 3.
Effect of different P2Y12 inhibitors on risk of bleeding in ACS patients established by network meta-analysis using random-effects models.
| Clopidogrel | Prasugrel | Ticagrelor | Cangrelor | |
|---|---|---|---|---|
| All major bleeding | ||||
| Clopidogrel | 1.00 | 1.24 (1.05–1.48) | 1.07 (0.97–1.19) | 1.01 (0.59–1.74) |
| Prasugrel | 0.80 (0.68–0.95) | 1.00 | 0.86 (0.72–1.03) | 0.81 (0.46–1.43) |
| Ticagrelor | 0.93 (0.84–1.03) | 1.16 (0.97–1.39) | 1.00 | 0.94 (0.55–1.63) |
| Cangrelor | 0.99 (0.58–1.69) | 1.23 (0.70–2.16) | 1.06 (0.61–1.83) | 1.00 |
| TIMI major bleeding | ||||
| Clopidogrel | 1.00 | 1.36 (1.11–1.66) | 1.02 (0.92–1.14) | 1.01 (0.59–1.74) |
| Prasugrel | 0.73 (0.60–0.90) | 1.00 | 0.75 (0.60–0.95) | 0.75 (0.42–1.32) |
| Ticagrelor | 0.98 (0.88–1.09) | 1.33 (1.06–1.67) | 1.00 | 0.99 (0.57–1.71) |
| Cangrelor | 0.99 (0.58–1.69) | 1.34 (0.76–2.38) | 1.01 (0.58–1.75) | 1.00 |
| Non-CABG-related TIMI major bleeding | ||||
| Clopidogrel | 1.00 | 1.26 (1.02–1.55) | 1.25 (1.01–1.52) | 1.00 (0.29–3.45) |
| Prasugrel | 0.80 (0.64–0.98) | 1.00 | 0.99 (0.75–1.32) | 0.80 (0.23–2.80) |
| Ticagrelor | 0.80 (0.66–0.97) | 1.01 (0.76–1.34) | 1.00 | 0.80 (0.23–2.81) |
| Cangrelor | 1.00 (0.29–3.46) | 1.26 (0.36–4.42) | 1.25 (0.36–4.38) | 1.00 |
| CABG-related TIMI major bleeding | ||||
| Clopidogrel | 1.00 | 1.32 (1.03–1.69) | 0.93 (0.81–1.06) | NAa |
| Prasugrel | 0.76 (0.59–0.97) | 1.00 | 0.70 (0.53–0.93) | NAa |
| Ticagrelor | 1.08 (0.95–1.23) | 1.42 (1.07–1.89) | 1.00 | NAa |
| Cangrelor | NAa | NAa | NAa | 1.00 |
| TIMI minor bleeding | ||||
| Clopidogrel | 1.00 | 1.44 (1.16–1.77) | 1.09 (0.93–1.28) | 1.47 (1.01–2.16) |
| Prasugrel | 0.70 (0.56–0.86) | 1.00 | 0.76 (0.58–0.99) | 1.03 (0.66–1.59) |
| Ticagrelor | 0.92 (0.78–1.08) | 1.32 (1.01–1.72) | 1.00 | 1.35 (0.89–2.04) |
| Cangrelor | 0.68 (0.46–0.99) | 0.97 (0.63–1.50) | 0.74 (0.49–1.12) | 1.00 |
Results are the Odds Ratios (95% Confidence Interval) in the column-defining therapy compared with the Odds Ratios in the row-defining therapy. For efficacy and safety, Odds Ratio <1 favors the column-defining therapy. Significant results are shown in bold.
ACS acute coronary syndrome, CABG coronary artery bypass grafting, NA not applicable, TIMI thrombolysis in myocardial infarction.
aCABG-related TIMI major bleeding was not reported in any comparison involving cangrelor.