Coronary artery diseaseMeta-analysis of effectiveness and safety of abciximab versus eptifibatide or tirofiban in percutaneous coronary intervention
Section snippets
Data ascertainment
MEDLINE (National Library of Medicine, Bethesda, Maryland) was queried under the search headings platelet inhibitors, angioplasty, and stent to obtain relevant publications. In addition, references from pertinent review articles as well as abstracts were analyzed. Eight articles were selected for further analysis that reported 30-day outcomes of death, myocardial infarction (MI), urgent or emergent revascularization, and major bleeding after the use of a parenteral GP IIb/IIIa inhibitor in a
Baseline characteristics
The inclusion criteria for each trial, the interventional modalities used, and the GP IIb/IIIa inhibitor administered are shown in Table 1. In all, 8,876 patients were assigned to active treatment, whereas 5,768 received placebo. Of the patients administered a GP IIb/IIIa inhibitor, 5,022 (57%) received abciximab and 3,854 (43%) received a small molecule inhibitor. All patients received heparin and aspirin in addition to the GP IIb/IIIa inhibitor (or placebo). The duration of treatment before
Discussion
We have combined the data for mortality, MI, urgent revascularization, and major bleeding at 30 days from 8 prospective, randomized trials involving patients undergoing PCI comparing GP IIb/IIIa antagonists with placebo. The combined size of these studies is large enough to detect clinically relevant differences in rates of death, MI, urgent revascularization, and major bleeding relative to placebo for the 2 major categories of GP IIb/IIIa inhibitors: abciximab and the small molecule
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