Colchicine for Prevention of Postoperative Atrial Fibrillation: Meta-Analysis of Randomized Controlled Trials

Salih, Mohsin; Smer, Aiman; Elmasry, Yansoun; Mlatoum, Hamza; Spinetto, Pedro Villablanca

doi:10.1016/s0735-1097(15)60268-6

Cited by 1 publication

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“…However, more researches are needed to compare different P2Y 12 receptor inhibitor pretreatment schemes and determine the optimal P2Y 12 inhibitor pretreatment program for patients with NSTE-ACS. Compared with previous meta-analyses (32)(33)(34)(35)(36)(37), our study showed some differences and advantages-this meta-analysis fully considered the differences in drug types, dosage, and administration timing of P2Y 12 inhibitors to evaluate the different pretreatment schemes; it summarizes all available information, including direct evidence and indirect estimates and provides the potential benefits and risks of each pretreatment method, and the age range of the patients included in the study was wide, ensuring the external validity of the results.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, several meta-analyses have discussed P2Y 12 inhibitor pretreatment ( 32 – 37 ), but there were differences in the types of objects in these meta-analyses. Some studies focused on patients with ACS or all patients receiving PCI ( 32 – 35 ) and did not distinguish between NSTE-ACS patients. Two meta-analyses discussed P2Y 12 inhibitor pretreatment in patients with NSTE-ACS, and one meta-analysis included patients with NSTE-ACS ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

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Effect of pretreatment with a P2Y12 inhibitor in patients with non-ST-elevation acute coronary syndrome: a systematic review and network meta-analysis

Lei

Zhao

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThis study aimed to systematically evaluate the effects of different types and doses of pretreatment with P2Y12 inhibitors in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).MethodsElectronic databases were searched for studies comparing pretreatment with different types and doses of P2Y12 inhibitors or comparison between P2Y12 inhibitor pretreatment and nonpretreatment. Electronic databases included the Cochrane Library, PubMed, EMBASE, and Web of Science. Literature was obtained from the establishment of each database until June 2022. The patients included in the study had pretreatment with P2Y12 inhibitors with long-term oral or loading doses, or conventional aspirin treatment (non-pretreatment). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs) during follow-up within 30 days after PCI, which included determining the composite endpoints of cardiac death, myocardial infarction, ischemia-driven revascularization, and stroke. The safety endpoint was a major bleeding event.ResultsA total of 119,014 patients from 21 studies were enrolled, including 13 RCTs and eight observational studies. A total of six types of interventions were included—nonpretreatment (placebo), clopidogrel pretreatment, ticagrelor pretreatment, prasugrel pretreatment, double loading pretreatment (double loading dose of clopidogrel, ticagrelor, prasugrel) and P2Y12 inhibitors pretreatment (the included studies did not distinguish the types of P2Y12 inhibitors, including clopidogrel, ticagrelor, and prasugrel). The network meta-analysis results showed that compared to patients without pretreatment, patients receiving clopidogrel pretreatment (RR = 0.78, 95% CI:0.66, 0.91, P < 0.05) and double-loading pretreatment (RR = 0.62, 95% CI:0.41, 0.95, P < 0.05) had a lower incidence of MACCEs. There was no statistically significant difference in the incidence of major bleeding events among the six pretreatments (P > 0.05).ConclusionsIn patients with NSTE-ACS, pretreatment with P2Y12 inhibitors before percutaneous intervention reduced the incidence of recurrent ischemic events without increasing the risk of major bleeding after PCI compared with nonpretreatment. Clopidogrel or double loading dose P2Y12 inhibitors can be considered for the selection of pretreatment drugs.

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