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已发表论文
替格瑞洛与其他 P2Y12 抑制剂联合口服抗凝药作为双联抗血小板治疗/单联抗血小板治疗的一部分在合并心房颤动和冠状动脉疾病的患者中的安全性与有效性比较：一项荟萃分析
Received 25 October 2025
Accepted for publication 28 December 2025
Published 30 December 2025 Volume 2025:21 Pages 1905—1913
DOI https://doi.org/10.2147/TCRM.S575007
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Garry Walsh
Yang Li,1,* Jing Gong,2,* Naifeng Liu1
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China; 2Department of Intensive Care Unit, Jiangsu Province Geriatric Hospital, Nanjing, 210009, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Naifeng Liu, Email liunf@seu.edu.cn
Objective: We performed a meta-analysis of randomized controlled trials to assess the safety and efficacy of ticagrelor or other P2Y12 inhibitors in combination with oral anticoagulants as a part of DAPT/SAPT for the patients with atrial fibrillation (AF) and acute coronary disease (ACS) or undergoing percutaneous coronary intervention (PCI).
Methods: We searched PubMed, Web of Science and ClinicalTrials.gov for randomized controlled trials (published from January 1, 1998, up to June 6, 2023; no language restrictions) comparing safety and efficacy of ticagrelor and DOACs or VKAs combination treatment arm with or without aspirin to other P2Y12 inhibitors treatment strategies. Main endpoints were clinically relevant bleeding as safety outcomes, all-cause mortality, and major adverse cardiovascular events (MACE) as efficacy outcomes.
Results: Of 248 identified studies, 3 were eligible and were included in our analysis (N= 9463 participants). Ticagrelor and DOAC or VKA combination treatment with or without aspirin strategy was associated with an increased rate of bleeding compared with clopidogrel (odds ratio [OR] 1.39, 95% CI 1.15 to 1.67, I2=0%). MACE was similar between ticagrelor versus clopidogrel (OR 1.00, 95% CI 0.54 to 1.86, I2=68.1%) and between ticagrelor versus prasugrel (OR 0.86, 95% CI 0.28 to 2.65, I2=0%).
Conclusion: The use of ticagrelor is associated with significantly higher rates of bleeding when compared with clopidogrel in patients with concomitant atrial fibrillation and coronary artery disease.
Keywords: atrial fibrillation, percutaneous coronary intervention, ticagrelor, other P2Y12 inhibitors, anticoagulation
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China; 2Department of Intensive Care Unit, Jiangsu Province Geriatric Hospital, Nanjing, 210009, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Naifeng Liu, Email liunf@seu.edu.cn
Objective: We performed a meta-analysis of randomized controlled trials to assess the safety and efficacy of ticagrelor or other P2Y12 inhibitors in combination with oral anticoagulants as a part of DAPT/SAPT for the patients with atrial fibrillation (AF) and acute coronary disease (ACS) or undergoing percutaneous coronary intervention (PCI).
Methods: We searched PubMed, Web of Science and ClinicalTrials.gov for randomized controlled trials (published from January 1, 1998, up to June 6, 2023; no language restrictions) comparing safety and efficacy of ticagrelor and DOACs or VKAs combination treatment arm with or without aspirin to other P2Y12 inhibitors treatment strategies. Main endpoints were clinically relevant bleeding as safety outcomes, all-cause mortality, and major adverse cardiovascular events (MACE) as efficacy outcomes.
Results: Of 248 identified studies, 3 were eligible and were included in our analysis (N= 9463 participants). Ticagrelor and DOAC or VKA combination treatment with or without aspirin strategy was associated with an increased rate of bleeding compared with clopidogrel (odds ratio [OR] 1.39, 95% CI 1.15 to 1.67, I2=0%). MACE was similar between ticagrelor versus clopidogrel (OR 1.00, 95% CI 0.54 to 1.86, I2=68.1%) and between ticagrelor versus prasugrel (OR 0.86, 95% CI 0.28 to 2.65, I2=0%).
Conclusion: The use of ticagrelor is associated with significantly higher rates of bleeding when compared with clopidogrel in patients with concomitant atrial fibrillation and coronary artery disease.
Keywords: atrial fibrillation, percutaneous coronary intervention, ticagrelor, other P2Y12 inhibitors, anticoagulation