Role of Vorapaxar After Coronary Revascularization Article

Full Text via DOI: 10.1016/j.amjcard.2015.12.051 PMID: 26851961 Web of Science: 000373523800005
International Collaboration

Cited authors

  • Sharma, Abhishek; Lavie, Carl J.; Helft, Gerard; Chatterjee, Saurav; Goel, Sunny; Garg, Aakash; Mukherjee, Debabrata; Marmur, Jonathan D.

Abstract

  • We aim to evaluate the potential benefit and risk of addition of vorapaxar to standard medical therapy in patients who underwent coronary revascularization with either percutaneous coronary revascularization or coronary artery bypass graft surgery. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled trials, and the clinical trial registry maintained at clinicaltrials.gov for randomized control trials evaluating the safety and efficacy of vorapaxar in patients who underwent coronary revascularization procedures with either percutaneous coronary revascularization or coronary artery bypass graft surgery. Event rates were compared using a Forest plot of relative risk using a random-effects model. The 5 studies (n = 24,025) that met all criteria were included in the final analysis. After coronary revascularization procedures, addition of vorapaxar to standard medical therapy was associated with reduction in the risk of myocardial infarction (MI; risk ratio 0.83 [0.75 to 0.92]) and ischemic stroke (0.011 [0.007 to 0.016]); however, it also resulted in significant increase risk of hemorrhagic stroke (1.57 [1.01 to 2.44]) and Thrombolysis In Myocardial Infarction major and minor bleeds (1.36 [1.07 to 1.70]). There was no significant difference in the risk of cardiovascular mortality (0.90 [0.73 to 1.09]), repeat revascularization (0.78 [0.23 to 2.70]), and stent thrombosis (0.95 [0.62 to 1.45]) in the vorapaxar and control groups. In conclusion, after coronary revascularization procedures, addition of vorapaxar to standard medical therapy was associated with reduction in the risk of MI and ischemic stroke and increase in risk of hemorrhagic stroke and Thrombolysis In Myocardial Infarction major and minor bleeds. (C) 2016 Elsevier Inc. All rights reserved.

Publication date

  • 2016

Published in

International Standard Serial Number (ISSN)

  • 0002-9149

Start page

  • 1059

End page

  • 1064

Volume

  • 117

Issue

  • 7