Previous studies have indicated that low-dose new generation of P2Y12 receptor antagonists may be more suitable compared with clopidogrel at a standard dose for the dual antiplatelet therapy (DAPT) for East Asian patients receiving percutaneous coronary intervention (PCI). However, there remains no consensus in clinical practice. Thus, in this study, we aimed to determine the efficacy and safety of low-dose P2Y12 receptor antagonists, compared to clopidogrel at a standard dose, in DAPT in East Asian patients after PCI. We systematically searched literatures for randomized controlled trials (RCT) comparing low-dose P2Y12 receptor antagonists with standard-dose clopidogrel for the treatment of East Asian patients undergoing PCI. The endpoints of efficacy include major adverse cardiac events (MACEs), all-cause mortality, and the number of target vessel revascularization. The indicators of safety include major and minor bleeding events. Heterogeneity was evaluated by I² statistic test. Begg's and Egger's tests were used to evaluate publication bias. In total, 2,747 subjects from 8 RCT studies were included. Low-dose new P2Y12 receptor antagonists, that is, ticagrelor or prasugrel, showed significantly lower incidence of MACEs, as compared with standard-dose clopidogrel, in the East Asian patients who are in DAPT after undergoing PCI. Further, no difference was noted for the risk of major and minor bleeding events. In East Asian patients undergoing PCI and receiving DAPT, the use of low-dose P2Y12 receptor antagonists, ticagrelor or prasugrel, has been determined to be superior than clopidogrel at standard dose; this has been evidenced by a lower incidence of MACEs without increasing the risk of bleeding.

先前的研究表明，与标准剂量的氯吡格雷相比，低剂量新一代 P2Y12 受体拮抗剂可能更适合接受经皮冠状动脉介入治疗 (PCI) 的东亚患者进行双重抗血小板治疗 (DAPT)。然而，在临床实践中仍未达成共识。因此，在本研究中，我们旨在确定与标准剂量的氯吡格雷相比，低剂量 P2Y12 受体拮抗剂在东亚患者 PCI 后 DAPT 中的疗效和安全性。我们系统地检索了随机对照试验 (RCT) 的文献，这些试验比较了低剂量 P2Y12 受体拮抗剂与标准剂量氯吡格雷治疗东亚患者接受 PCI 的疗效。疗效终点包括主要不良心脏事件 (MACE)、全因死亡率、以及靶血管血运重建的次数。安全性指标包括大出血和小出血事件。异质性评价为I ²统计检验。Begg's 和 Egger's 检验用于评估发表偏倚。总共包括来自 8 项 RCT 研究的 2,747 名受试者。与标准剂量的氯吡格雷相比，在接受 PCI 后接受 DAPT 的东亚患者中，低剂量的新型 P2Y12 受体拮抗剂，即替格瑞洛或普拉格雷，MACE 的发生率显着降低。此外，大出血事件和小出血事件的风险没有差异。在接受 PCI 并接受 DAPT 的东亚患者中，已确定使用低剂量 P2Y12 受体拮抗剂替格瑞洛或普拉格雷优于标准剂量的氯吡格雷；MACE 的发生率较低，但不会增加出血风险，这证明了这一点。