Background
Methods
Ethics
Search strategy
Selection
Validity assessment
Data abstraction
Study characteristics
Quantitative data synthesis
Results
Trial flow/flow of included studies
Control group | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Study | N | Age | Male (%) | Asp | TP | GP | Triple group | Heparin | Length of treatment | Length of follow-up (months) | Quality* |
NSTE-ACS | |||||||||||
ADVANCE[41] | 202 | 69 | 68 | √ | √ | Tirofiban | √ | 48 h | 6 | A | |
ELISA-2[42] | 328 | 64 | 71 | √ | √ | Tirofiban |
-
| 12 h | 1 | A | |
ISAR-REACT-2[43] | 2,022 | 66 | 75 | √ | √ | Abciximab | √ | 12 h | 1 | A | |
PROTECT-TIMI-30[44] | 857 | 60 | 67 | √ | √ | Eptifibatide | √ | 24 h | 48 h | A | |
STEMI | |||||||||||
ADMIRAL[45] | 300 | 61 | 82 | √ | √ | Abciximab | √ | 12 h | 6 | A | |
ACE[46] | 400 | 64 | 77 | √ | √ | Abciximab | √ | 12 h | 6 | A | |
CADILLAC [47] | 2082 | 60 | 73 | √ | √ | Abciximab | √ | 12 h | 6 | B | |
Ernst/1[48] | 60 | 61 | 74 | √ | √ | Abciximab | √ | 12 h | 1 | B | |
Ernst/2[48] | 60 | 60 | 82 | √ | √ | Tirofiban | √ | 12 h | 1 | B | |
Ernst/3[48] | 59 | 61 | 76 | √ | √ | Tirofiban high dose | √ | 12 h | 1 | B | |
ISAR 2[30] | 401 | 61 | 76 | √ | √ | Abciximab | √ | 12 h | 1 | B | |
Neumann[31] | 200 | 60 | 77 | √ | √ | Abciximab | √ | 12 h | 1 | B | |
Petronio[49] | 31 | 57 | 87 | √ | √ | Abciximab | √ | 12 h | 1 | B | |
Kim[50] | 60 | 63 | 70 | √ | √ | Cilostazol | √ | 1 month | 1 | B | |
Elective PCI | |||||||||||
Claeys[51] | 200 | 67 | 70 | √ | √ | Abciximab | √ | 12 h | 6 | B | |
EPISTENT[52] | 1,603 | 59 | 75 | √ | √ | Abciximab | √ | 13 h | 1 | A | |
ESPRIT[35] | 2,064 | 62 | 73 | √ | √ | Eptifibatide | √ | 24 h | 1 | B | |
ISAR-REACT[53] | 2,159 | 66 | 77 | √ | √ | Abciximab | √ | 12 h | 1 | A | |
ISAR-SMART-2[54] | 502 | 66 | 73 | √ | √ | Abciximab | √ | 12 h | 12 | A | |
ISAR-SWEET[55] | 701 | 68 | 75 | √ | √ | Abciximab | √ | 12 h | 12 | A | |
TOPSTAR[56] | 96 | 65 | 75 | √ | √ | tirofiban | √ | 42 h | 9 | A | |
MR PCI/1[57] | 60 | 61 | 85 | √ |
-
| √ | Clopidogrel | √ | 30 days | 1 | A |
MR PCI/2[57] | 60 | 56 | 85 | √ |
-
| √ | Clopidogrel | √ | 30 days | 1 | A |
DECLARE-Long[58] | 500 | 61 | 64 | √ | √ | Cilostazol |
-
| 6 months | 6 | A | |
DECLARE-DIABETES[59] | 400 | 61 | 58 | √ | √ | Cilostazol |
-
| 6 months | 6 | A | |
Min[60] | 59 | 62 | 66 | √ | √ | Cilostazol | √ | 1 month | 6 | A | |
CREST[61] | 705 | 60 | 74 | √ | √ | Cilostazol |
-
| 6 months | 6 | A | |
Han[62] | 1212 | 60 | 73 | √ | √ | Cilostazol |
-
| 6 months | 12 | A |
Study characteristics
Quantitative data synthesis
GP IIb/IIIa inhibitors
Patients | Intervention | Myocardial infarction | Composite vascular event | Death | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Triple events/total | Control events/total | OR* (95% CI) | Triple events/total | Control events/total | OR* (95% CI) | Triple events/total | Control events/total | OR* (95% CI) | ||
NSTE-ACS | GP IIb/IIIa | 195/1848 | 232/1558 |
0.70 (0.56-0.88)
| 202/1848 | 244/1558 |
0.69 (0.55-0.86)
| 14/1848 | 19/1558 | 0.72 (0.36-1.43) |
STEMI | GP IIb/IIIa | 32/1771 | 117/1683 |
0.26 (0.17-0.38)
| 88/1771 | 203/1683 |
0.39 (0.30-0.51)
| 56/1771 | 78/1683 |
0.69 (0.49-0.99)
|
Cilostazol | 2/30 | 1/30 | 2.07 (0.18-24.15) | |||||||
Elective PCI | GP IIb/IIIa | 170/3615 | 244/3614 | 0.77 (0.54-1.11) | 195/3515 | 268/3514 | 0.78 (0.54-1.12) | 33/3515 | 37/3514 | 0.90 (0.55-1.46) |
Cilostazol | 17/1439 | 16/1437 | 1.07(0.53-2.16) | 46/1408 | 57/1409 | 0.86(0.40-1.85) | 20/1439 | 29/1437 | 0.70(0.39-1.25) | |
Clopidogrel | 2/60 | 2/60 | 0.95 (0.13-6.74) |
Other agents
Adverse events
Patients | Intervention | Major bleeding | Minor bleeding | Blood transfusions | Thrombocytopenia | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Triple events/total | Control events/total | OR *(95% CI) | Triple events/total | Control events/total | OR* (95% CI) | Triple events/total | Control events /total | OR* (95% CI) | Triple events/total | Control events/total | OR* (95% CI) | ||
NSTE-ACS | GP IIb/IIIa | 34/1275 | 30/1274 | 1.15 (0.69-1.91) | 46/1113 | 34/1111 | 1.37 (0.81-2.33) | 45/1174 | 36/1173 | 1.27 (0.81-2.00) | 8/1012 | 0/1010 | 17.1 (0.99-296.69) |
STEMI | GP IIb/IIIa | 11/255 | 2/195 | 1.86 (0.43-8.17) | 23/255 | 7/195 |
2.73 (1.15-6.46)
| 10/281 | 15/272 | 0.63 (0.28-1.44) | 11/238 | 4/181 | 1.51 (0.48-4.71) |
Cilostazol | 0/30 | 0/30 | |||||||||||
Elective PCI | GP IIb/IIIa | 42/3314 | 34/3309 | 1.29 (0.70-2.36) | 99/3314 | 62/3309 |
1.60 (1.16-2.21)
| 71/3264 | 40/3263 |
1.79 (1.14-2.79)
| 17/2269 | 0/2250 |
8.04 (1.82-35.59)
|
Cilostazol | 0/1054 | 1/1058 | 0.33 (0.01-8.24) | 6/1054 | 7/1058 | 0.85(0.28-2.56) | 1/450 | 2/450 | 0.62 (0.08-5.09) | ||||
Clopidogrel | 1/60 | 0/60 | 3.10 (0.12-79.29) | 1/60 | 0/60 | 3.10 (0.12-79.23) |