Objective To systematically evaluate the efficacy and safety of the use of ticagrelor in patients with coronary artery disease combined with chronic kidney disease after percutaneous coronary intervention(PCI).Methods Computerized searches were performed on China National Knowledge Infrastructure(CNKI),Wan Fang Data Knowledge Service Platform(WanFang),Vip Chinese Science and Technology Journal Database(VIP),PubMed,Web of Science,Embase,and Cochrane Library databases.The quality of the included studies was evaluated according to the Cochrane Handbook of Systematic Evaluation and the Newcastle-Ottawa Scale(NOS)scale.Meta-analysis was performed using Stata 15.0.Results A total of 10 studies,involving 4 randomized controlled trials(RCTs)and 6 cohort studies,were included,enrolling a total of 8 110 post-PCI patients with coronary artery disease combined with chronic kidney disease.There were 3 356 patients in the trial group and 4 754 patients in the control group.Meta-analysis results showed that,in terms of effectiveness,the incidence of major adverse cardiovascular and cerebrovascular events(MACCE)(OR=0.78,95%CI:0.68-0.89,P<0.001),and that of myocardial infarction(OR=0.76,95%CI:0.62-0.93,P<0.001)in the patients were statistically different between the two groups.Comparing the incidence of all-cause death(OR=0.81,95%CI:0.59-1.10,P=0.179),cardiac death(OR=0.76,95%CI:0.54-1.05,P=0.542),stroke(OR=0.87,95%CI:0.65-1.17,P=0.354),and repetitive revascularization(OR=0.73,95%CI:0.51-1.04,P=0.077)between the two groups,the difference was not statistically significant.In terms of safety,there was no statistically significant difference in the incidence of bleeding(OR=1.12,95%CI:0.85-1.46,P=0.432)between the two groups.Conclusion The treatment of post-PCI patients with coronary artery disease combined with chronic kidney disease by using ticagrelor is effective in reducing the incidence of MACCE and myocardial infarction without increasing the risk of bleeding.Meanwhile,the incidence of all-cause mortality,cardiac death,stroke,and repetitive revascularization in the trial group is comparable in efficacy to that of the control group.
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