Meta-Analysis of Comparison of the Newer Oral XXXX Inhibitors ( @entity3076 or @entity3077 ) to @entity1397 in @entity1 With Non-ST-Elevation Acute Coronary Syndrome.

@entity1 @entity1187 @entity3076 @entity64 @entity548 @entity1397 @entity3077 @entity583 @entity3075 @entity65
UNASSIGNED: Newer oral @entity3075 inhibitors are more potent and have faster onset of action than @entity1397 . However, the efficacy and safety in @entity1 with non-ST-elevation @entity1187 (NSTE-ACS) are not well studied. A systemic search of MEDLINE and EMBASE databases was performed to identify randomized clinical trials comparing newer oral @entity3075 inhibitors ( @entity3076 or @entity3077 ) to @entity1397 in @entity1 with NSTE-ACS. The primary outcome was a composite of @entity65 , @entity583 ( @entity583 ), and @entity64 (major cardiovascular events [MACE]). Secondary outcomes were individual components of the primary outcome, all-cause mortality, and Thrombolysis In @entity583 (TIMI) major and @entity548 . A total of 31,470 @entity1 with NSTE-ACS from 4 randomized clinical trials were included (newer oral @entity3075 inhibitors: 15,951; @entity1397 : 15,519). Newer oral @entity3075 inhibitors significantly decreased MACE (relative risk [RR] 0.87, 95% confidence interval [CI] 0.80 to 0.95) and @entity583 (RR 0.85, 95% CI 0.75 to 0.96) and showed a trend toward reduction of @entity65 (RR 0.89, 95% CI 0.71 to 1.01). There was a significant increase in TIMI major @entity548 (RR 1.27, 95% CI 1.07 to 1.50) and TIMI major or @entity548 (RR 1.20, 95% CI 1.02 to 1.42). Results were largely similar when stratified by @entity3077 versus @entity3076 (pinteraction >0.05) except for increased TIMI major/ @entity548 with @entity3076 than @entity3077 (pinteraction  = 0.01). In conclusion, in @entity1 with NSTE-ACS, newer oral @entity3075 inhibitors decrease MACE and @entity583 at the expense of a significant increase in the risk of @entity548 . Treatment of 1,000 @entity1 with newer oral @entity3075 inhibitors will prevent 16 MACE and 13 MIs at the expense of increase in 6 major @entity548 events.
