title: High on-treatment platelet reactivity with ticagrelor versus prasugrel: a systematic review and meta-analysis.
abstract: BACKGROUND
  Ticagrelor and prasugrel have shown superiority over clopidogrel. However, it remains unclear if one is superior to another regarding on-treatment platelet reactivity.
  
  
  OBJECTIVE
  To compare the impact of ticagrelor and prasugrel on high on-treatment platelet reactivity (HTPR).
  
  
  METHODS
  The PubMed and Cochrane databases were searched for eligible studies in December 2014. Studies were eligible if they compared ticagrelor and prasugrel regarding high on-treatment platelet reactivity (HTPR). Pooled estimates were calculated by using a random-effects model with 95% confidence intervals.
  
  
  RESULTS
  We included 14 studies and 1822 patients: 805 and 1017 in the ticagrelor and prasugrel groups, respectively. The rate of HTPR was significantly lower in the ticagrelor group: 1.5% vs. 9.8% (RR = 0.27 [0.14-0.50]). The pre-specified analysis focusing on randomized trials (n = 10) showed consistent results (RR = 0.27 [0.12-0.60]).
  
  
  CONCLUSIONS
  Our results suggest that ticagrelor allows a higher platelet reactivity inhibition as compared with prasugrel and leads to a further decrease in the rate of HTPR.
authors: Centre Hospitalier Régional et Universitaire de Lille, Lille, France.|Inserm U744, Institut Pasteur de Lille, Lille, France.|Faculté de Médecine de l'Université de Lille, Lille, France.
authors: G
authors: G
authors: Lemesle
authors: Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
authors: G
authors: G
authors: Schurtz
authors: Centre Hospitalier Régional et Universitaire de Lille, Lille, France.|Inserm U744, Institut Pasteur de Lille, Lille, France.|Faculté de Médecine de l'Université de Lille, Lille, France.
authors: C
authors: C
authors: Bauters
authors: Centre Hospitalier Universitaire de Caen, Caen, France.|Faculté de Médecine de Caen, Caen, France.
authors: M
authors: M
authors: Hamon
mesh_terms: D000241:Adenosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D016009:Chi-Square Distribution; D004351:Drug Resistance; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010979:Platelet Function Tests; D000068799:Prasugrel Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012307:Risk Factors; D000077486:Ticagrelor; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine
keywords: acute coronary syndrome; antiplatelet agents; coronary artery disease; percutaneous coronary intervention; platelet function tests