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Prevents blood clots from forming during a procedure to open blocked blood vessels.

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Results: 21 to 40 of 40

Early administration of small-molecule glycoprotein IIb/IIIa inhibitors before primary percutaneous coronary intervention for ST-elevation myocardial infarction: insights from randomized clinical trials

The review found that, in the setting of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, early administration of small-molecule glycoprotein IIb/IIIa receptor inhibitors appeared to be as effective and safe as abciximab. This conclusion should be interpreted with some caution due to the lack of data for long-term outcomes and the lack of trial quality assessment.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Tirofiban as adjunctive therapy for acute coronary syndromes and percutaneous coronary intervention: a meta-analysis of randomized trials

This review concluded that adjunctive tirofiban reduced clinical outcomes including mortality, but increased minor bleeding, when compared with placebo in patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Compared with abciximab, the effect was less favourable at lower doses, but similar at higher doses. Overall, the review was well conducted and the conclusions appear reasonable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Efficacy and safety of early versus late glycoprotein IIb/IIIa inhibitors for PCI

BACKGROUND: Glycoprotein (Gp) IIb/IIIa inhibitors are beneficial for patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). However, optimal drug timing remains inconclusive. Therefore, this study was to perform a meta-analysis of the clinical efficiency and safety of early versus late GpIIb/IIIa inhibitors in STEMI patients undergoing PCI.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Treatment with tirofiban for acute coronary syndrome (ACS): a systematic review and network analysis

Compared to usual care, tirofiban was more effective for patients with ST elevated myocardial infarction and for patients with non-ST elevated acute coronary syndrome with scheduled percutaneous coronary intervention or medical management. Tirofiban and abciximab were equally effective. Analyses included few studies and a lack of reporting of several study results make the reliability of the conclusions unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Early glycoprotein IIb IIIa inhibitors in primary angioplasty (EGYPT) cooperation: an individual patient data meta-analysis

This review concluded that early administration of glycoprotein IIb-IIIa inhibitors in patients who underwent primary angioplasty for ST-segment elevation myocardial infarction was associated with significant benefits in pre-procedural epicardial recanalisation and ST-segment resolution. These translated into non-significant mortality benefits, except with abciximab, where there was a significant reduction in mortality. These conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Glycoprotein IIb‐IIIa inhibitors for acute ischaemic stroke

Question: We wanted to evaluate the safety and effectiveness of GP IIb‐IIIa inhibitors, alone or in combination with thrombolytic agents, in individuals with acute ischaemic stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Risk profile and benefits from Gp IIb-IIIa inhibitors among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-regression analysis of randomized trials

The review concluded that among ST elevation myocardial infarction patients who underwent primary angioplasty, there is a significant relationship between risk profile and benefits from adjunctive Gp IIb-IIIa inhibitors in terms of mortality. The lack of a study quality assessment and an over-emphasis on significant results mean the authors' conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Upstream vs deferred administration of small-molecule glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: insights from randomized clinical trials

This generally high-standard review concluded that administration of small-molecule glycoprotein inhibitors prior (upstream) rather than during percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction did not translate into improvements in post-procedural angiographic, clinical or safety outcomes, despite initial epicardial patency improvement. Although there was no discussion of quality issues, these conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Meta-analysis of randomized controlled trials of intracoronary versus intravenous administration of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention for acute coronary syndrome

This review compared intracoronary with intravenous administration of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention in patients with acute coronary syndrome. The authors concluded that intracoronary bolus showed favourable short-term improvements in outcomes, with the exception of bleeding rates. Given the limitations of the generally poor quality trials and review reporting issues, the conclusions should be interpreted cautiously.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Facilitated angioplasty with combo therapy among patients with ST-segment elevation myocardial infarction: a meta-analysis of randomized trials

The authors concluded that in patients with ST-segment elevation myocardial infarction who underwent primary angioplasty, glycoprotein (Gp) IIb-IIIa inhibitors plus reduced lytic therapy was not superior to Gp IIb-IIIa inhibitors alone and could not be routinely recommended. These conclusions appeared to reflect the evidence, but incomplete reporting of review methods and absence of validity assessment means their reliability is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Triple antiplatelet therapy for preventing vascular events: a systematic review and meta-analysis

The review concluded that triple antiplatelet therapy based on intravenous glycoprotein IIb/IIIa inhibitors reduced vascular events compared with aspirin-based dual therapy in patients with non-ST elevation with acute coronary and ST elevation with myocardial infarction, but increased minor bleeding in some specified subgroups. Limited assessment of trial quality makes it difficult to judge the strength of these conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Drugs to prevent the re‐occurrence of narrowing of blood vessels in peripheral arterial disease after the blood vessels have been surgically widened

Peripheral arterial disease of leg arteries can progressively cause leg pain on walking, pain at rest, ulcers and gangrene because of reduced blood flow. An inflatable balloon catheter inserted into the artery is used to widen and unblock the affected artery (termed angioplasty) yet reoccurrence of narrowing (restenosis) or obstruction (reocclusion) frequently occurs because of platelet clumping (aggregation) and activated blood clotting in the damaged blood vessel. This review of 22 randomised clinical trials, with a combined total of 3529 patients, set out to determine if any drug was more effective than another in preventing occlusion or restenosis of the artery after the blood vessels have been surgically widened. For the majority of comparisons, only one study was available. Evidence suggests that some drugs which reduce platelet aggregation, such as higher‐dose aspirin, can reduce the rate of reocclusion six months after surgery, but evidence on associated side effects and for longer‐term restenosis rates is scarce. There is also some evidence of variation in effect according to different drugs, with reocclusion/restenosis rates lower in people taking cilostazol compared with ticlopidine 12 months after surgery and, in patients with more severe disease, those taking low molecular weight heparin in addition to aspirin compared with aspirin alone. Batroxobin plus aspirin compared with aspirin alone may be an effective treatment in diabetic patients. However, available trials are generally small and of variable quality and side effects of drugs are not consistently addressed. Further good quality, large‐scale randomised controlled trials, grouped by severity of disease, are required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Effects of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention after pretreatment with clopidogrel: a meta-analysis of randomized trials

The authors concluded that the use of glycoprotein IIb/IIa in patients pre-treated with clopidogrel did not reduce death, post-procedural myocardial infarction or TVR and significantly increased the risk of bleeding. Due to the inadequate reporting of study quality, questionable pooling of data and flaws with the review process, the authors' conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Meta-analysis of randomized trials of glycoprotein IIb/IIIa inhibitors in high-risk acute coronary syndromes patients undergoing invasive strategy

The review concluded that, in high-risk acute coronary syndrome patients undergoing an early invasive strategy, upstream glycoprotein IIb/IIIa inhibitors did not improve clinical outcomes and increased the risk of major bleeding compared with selective downstream glycoprotein inhibitors. The authors' conclusions reflected the evidence base, but lack trial quality reporting and potential bias mean the conclusions should be considered tentative.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Early vs late administration of glycoprotein 11b/111a inhibitors in primary percutaneous coronary intervention of acute ST-segment elevation myocardial infarction: a meta analysis

This review compared administration at first contact with delayed administration in the catheterisation laboratory. It found a significant benefit of early treatment for angiographic outcomes and trends favouring early treatment for clinical outcomes. The evidence presented supports the authors' conclusions, but the conclusions should be treated cautiously because the validity of studies included in the review was not assessed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Treatment Strategies for Patients With Peripheral Artery Disease [Internet]

For patients with peripheral artery disease (PAD), the optimal treatment for cardiovascular protection, symptom relief, preservation of walking and functional status, and prevention of amputation is not known. This review assessed the comparative effectiveness of antiplatelet therapy, medical therapy, exercise, and endovascular and surgical revascularization in PAD patients with intermittent claudication (IC) or critical limb ischemia (CLI).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2013
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Treatment Strategies for Women With Coronary Artery Disease [Internet]

Although coronary artery disease (CAD) is the leading cause of death for women in the United States, treatment studies to date have primarily enrolled men and may not reflect the benefits and risks that women experience. Our systematic review of the medical literature assessed the comparative effectiveness of major treatment options for CAD specifically in women. The comparisons were (1) percutaneous coronary intervention (PCI) versus fibrinolysis/supportive pharmacologic therapy in ST elevation myocardial infarction (STEMI), (2) early invasive versus initial conservative management in non-ST elevation myocardial infarction (NSTEMI) or unstable angina, and (3) PCI versus coronary artery bypass surgery (CABG) versus optimal medical therapy in stable or unstable angina. The endpoints assessed were clinical outcomes, modifiers of effectiveness by demographic and clinical factors, and safety outcomes.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: August 2012
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Cost-effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: systematic review and decision-analytical modelling

This review supported the use of glycoprotein antagonists for all patients with non-ST elevation acute coronary syndrome, as part of their initial medical management. Nearly all the benefit could be attained by treating high-risk patients.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Cost-effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: systematic review and decision-analytical modelling

This report describes the development of a decision model to evaluate the cost-effectiveness of glycoprotein IIb/IIIa antagonists (GPAs) in non-ST elevation acute coronary syndrome (ACS) and the systematic review that was undertaken to populate that model. A more general literature review has been published in a separate issue of Health Technology Assessment as an update report from an earlier Technology Assessment Review for the National Institute for Health and Clinical Excellence (NICE).

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: 2005

Type 1 Diabetes in Adults: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

Type 1 diabetes can, if poorly controlled, produce devastating problems in both the short and the long term. Good control of blood glucose levels reduces the risk of these problems arising, but can be very difficult for patients and carers to achieve. This guideline emphasises that the NHS should provide all patients with the means – and the necessary understanding – to control their diabetes, and that it should help patients integrate the disease management with their other activities and goals. It argues that every person with diabetes should be able to develop their own care plan and utilise effective treatment in a way agreeable to them. The input of various health professionals may be needed to achieve this, and should be readily available. A system of regular monitoring, so that any complications which do develop are picked up at an early stage and treated appropriately, should also be provided.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2004
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