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Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions.

Publication ,  Journal Article
Kong, DF; Hasselblad, V; Harrington, RA; White, HD; Tcheng, JE; Kandzari, DE; Topol, EJ; Califf, RM
Published in: Am J Cardiol
September 15, 2003

We performed a cumulative meta-analysis of available studies to evaluate the effect of intravenous platelet glycoprotein (GP) IIb/IIIa antagonists on survival at 30 days and 6 months after percutaneous coronary intervention (PCI). Compounds that block the GP IIb/IIIa receptor substantially reduce myocardial infarctions (MIs) and repeat revascularization. We included 12 trials, which enrolled 20,186 patients in all, in the analysis. Overall, 30-day mortality was significantly reduced with GP IIb/IIIa inhibition (odds ratio 0.73, 95% confidence interval 0.55 to 0.96, p = 0.024). Although 10 of the 12 trials showed a beneficial effect of GP IIb/IIIa inhibitor treatment on mortality, no individual trial detected a statistically significant mortality benefit. The 30-day mortality benefit became significant at the p <0.05 level with addition of the ADMIRAL trial and was further enhanced by the CADILLAC trial. No significant heterogeneity was detected in the collection of trials. At 6 months, the odds ratio was 0.84 (95% confidence interval 0.69 to 1.03, p = 0.087). This survival benefit amounts to preventing approximately 1 of every 3 deaths that occur within 30 days after PCI, saving 2.8 lives/1,000 patients treated (number needed to treat, 357). Thus, patients who undergo PCI can expect significantly lower 30-day mortality, in addition to known reductions in nonfatal MI and repeat procedures, with GP IIb/IIa inhibition. There also is increasing evidence that mortality reductions are preserved at 6 months.

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Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

September 15, 2003

Volume

92

Issue

6

Start / End Page

651 / 655

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Randomized Controlled Trials as Topic
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Infusions, Intravenous
  • Humans
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
 

Citation

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Kong, D. F., Hasselblad, V., Harrington, R. A., White, H. D., Tcheng, J. E., Kandzari, D. E., … Califf, R. M. (2003). Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions. Am J Cardiol, 92(6), 651–655. https://doi.org/10.1016/s0002-9149(03)00816-6
Kong, David F., Vic Hasselblad, Robert A. Harrington, Harvey D. White, James E. Tcheng, David E. Kandzari, Eric J. Topol, and Robert M. Califf. “Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions.Am J Cardiol 92, no. 6 (September 15, 2003): 651–55. https://doi.org/10.1016/s0002-9149(03)00816-6.
Kong DF, Hasselblad V, Harrington RA, White HD, Tcheng JE, Kandzari DE, et al. Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions. Am J Cardiol. 2003 Sep 15;92(6):651–5.
Kong, David F., et al. “Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions.Am J Cardiol, vol. 92, no. 6, Sept. 2003, pp. 651–55. Pubmed, doi:10.1016/s0002-9149(03)00816-6.
Kong DF, Hasselblad V, Harrington RA, White HD, Tcheng JE, Kandzari DE, Topol EJ, Califf RM. Meta-analysis of survival with platelet glycoprotein IIb/IIIa antagonists for percutaneous coronary interventions. Am J Cardiol. 2003 Sep 15;92(6):651–655.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

September 15, 2003

Volume

92

Issue

6

Start / End Page

651 / 655

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Randomized Controlled Trials as Topic
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Infusions, Intravenous
  • Humans
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary