Authors reply to the letter regarding “Ticagrelor for Asian patients with acute coronary syndrome in real-world practice: a systematic review and meta-analysis of observational studies”

OBJECTIVE:We aimed to assess the efficacy and safety of ticagrelor compared to clopidogrel in Asian patients with acute coronary syndrome (ACS) in real-world practice. METHODS:PubMed, Web of Science and Scopus databases were searched systematically to obtain relevant Asian observational studies. RESULTS:The meta-analysis included six studies with 27959 participants. Compared with clopidogrel, ticagrelor was significantly beneficial in prevention of major adverse cardiac events (MACCEs) (OR=0.62; 95% CI: 0.46-0.83, I 22222222CONCLUSION:This meta-analysis suggested that ticagrelor might reduce the risk of MACCEs mainly by reducing stroke in Asian patients with ACS without increasing the rates of major bleeding. Ticagrelor did not show a significant effect on other parts of MACCEs. Considerable increase in the risk of major/minor and minor bleeding was observed in ticagrelor compared with clopidogrel users. Further high-quality studies are required to support these findings.