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Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stenting

Deepak L. Bhatt, MD^*, Michel E. Bertrand, MD, FACC, Peter B. Berger, MD, FACC, Philippe L. L’Allier, MD, Issam Moussa, MD, FACC^||, Jeffrey W. Moses, MD, FACC^||, George Dangas, MD, PhD, FACC^||, Megumi Taniuchi, MD, FACC^¶, John M. Lasala, MD, FACC^¶, David R. Holmes, MD, FACC, Stephen G. Ellis, MD, FACC^* and Eric J. Topol, MD, FACC^*,*

^* Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Hopital Cardiologique, Lille, France
Mayo Clinic, Rochester, Minnesota, USA
Montreal Heart Institute, Montreal, Canada
^|| Lenox Hill Heart and Vascular Institute, New York, New York, USA
^¶ Washington University, St. Louis, Missouri, USA

View larger version (25K): [in a new window]   Figure 1 The odds ratio (OR) plots with 95% confidence intervals (CIs) for the rate of 30-day major adverse cardiac events (MACE) for each of the trials individually, as well as for the pooled data. Estimates to the left of the centerline reflect that clopidogrel was more effective; those to the right of the centerline indicate that ticlopidine was more effective. The size of the boxes corresponds to the number of patients in the trial. Arrows indicate that the limits of the CI extend beyond the graph. CCF = Cleveland Clinic Foundation; CLASSICS = CLopidogrel ASpirin Stent International Cooperative Study; TOPPS = Ticlid Or Plavix Post-Stent.

View larger version (27K): [in a new window]   Figure 2 The odds ratio (OR) plots with 95% confidence interval (CIs) for the rate of 30-day mortality. The boxes for the CLopidogrel ASpirin Stent International Cooperative Study (CLASSICS) and North Memorial studies reflect directionality and sample size, but true ORs cannot be determined, because both trials had an arm with a point estimate of zero. Arrows indicate that the limits of the CI extend beyond the graph. CCF = Cleveland Clinic Foundation; TOPPS = Ticlid Or Plavix Post-Stent.

View larger version (15K): [in a new window]   Figure 3 The odds ratio plots with 95% confidence intervals (CIs) for the rates of the individual components of the composite end point. MACE = major adverse cardiac events; MI = myocardial infarction; SAT = subacute stent thrombosis; TVR = target vessel revascularization.