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Benefits from small molecule administration as compared with abciximab among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-analysis

Similar angiographic, electrocardiographic, and clinical outcomes were observed when abciximab was compared with small molecules (eptifibatide and tirofiban) among ST-segment elevation myocardial infarction patients undergoing primary angioplasty. This review appeared to be generally well-conducted, but it is difficult to assess the reliability of the findings without further information on the quality of the included trials.

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

Version: 2009

Glycoprotein IIb/IIIa antagonists: a systematic review of randomized clinical trials in patients undergoing percutaneous coronary intervention

This review concluded that intravenous glycoprotein IIb/IIIa inhibitor drugs can significantly reduce the risk of heart attacks and need for bypass surgery in patients undergoing percutaneous coronary interventions, but can also increase the risk of minor bleeding. This was a well conducted systematic review and the 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: 2005

Intravenous glycoprotein IIb/IIIa receptor antagonists reduce mortality after percutaneous coronary interventions

This review evaluated the impact of intravenous platelet glycoprotein IIb/IIIa receptor antagonists on mortality in patients undergoing percutaneous coronary intervention. Glycoprotein IIb/IIIa receptor antagonists were found to confer a significant and sustained decrease in the risk of death. Although full details of the methods of the review were not given, the conclusions are supported by the evidence presented.

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

Version: 2003

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

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

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

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

Effectiveness and safety of glycoprotein IIb/IIIa inhibitors in patients with myocardial infarction undergoing primary percutaneous coronary intervention: a meta-analysis of observational studies

The study found that treatment with glycoprotein IIb/IIIa inhibitors was associated with reductions in mortality, re-infarction and repeat percutaneous coronary intervention in patients with myocardial infarction with ST segment elevation, outside the setting of a randomised controlled trial. Limitations of the review methodology and reporting mean that the reliability of the authors' conclusions is uncertain.

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

Version: 2011

A comparison of intracoronary with intravenous glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention in patients with acute coronary syndrome: a meta-analysis of randomized controlled trials

This review concluded that compared to intravenous administration, intra-coronary glycoprotein IIb/IIIa inhibitors did not significantly improve clinical outcomes in people undergoing percutaneous coronary intervention for acute coronary syndromes. However, there was an increase in target coronary flow and myocardial perfusion. The review appears generally well conducted and conclusions appear reasonable given the evidence presented.

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

Version: 2012

Routine upstream versus selective downstream administration of glycoprotein IIb/IIIa inhibitors in patients with non-ST-elevation acute coronary syndromes: a meta-analysis of randomized trials

This review found reductions in ischaemic events in patients with non-ST-elevation acute coronary syndromes undergoing invasive cardiac surgery and receiving early (routine upstream) administration of glycoprotein IIb/IIIa inhibitors compared with deferred (selective downstream) administration of glycoprotein IIb/IIIa inhibitors. However, early therapy was associated with increased bleeding complications. The authors' 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: 2012

Aspirin "resistance" and risk of cardiovascular morbidity: systematic review and meta-analysis

The authors concluded that aspirin resistance adversely affects clinical outcomes in patients with cardiovascular disease, whether aspirin is used alone or with another antiplatelet agent. These conclusions appear to be supported by the data presented, but poor reporting of review methods, differences between the studies and possible publication bias mean that they should be treated with some caution.

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

Version: 2008

A comparison of abciximab and small-molecule glycoprotein IIb/IIIa inhibitors in patients undergoing primary percutaneous coronary intervention: a meta-analysis of contemporary randomized controlled trials

The authors concluded that no difference could be identified between abciximab and small-molecule glycoprotein IIb/IIIa inhibitors in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. The authors’ conclusions reflected the evidence presented, but incomplete reporting of review methods and lack of reporting of trial validity make it difficult to assess their reliability.

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

Version: 2009

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

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

Efficacy and safety of unfractionated heparin plus glycoprotein IIb/IIIa inhibitors during revascularization for an acute coronary syndrome: a meta-analysis of randomized trials performed with stents and thienopyridines

The review found adding glycoprotein IIb/IIIa inhibitors to unfractionated heparin reduced myocardial infarction and revascularisation rates without increasing major bleeding among patients undergoing revascularisation for acute coronary syndrome using stents and thienopyridine. The intervention increased minor bleeding. Groups had similar mortality rates. These conclusions are probably reliable but the review included poor quality and non placebo-controlled trials.

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

Version: 2012

ST-segment resolution and prognosis after facilitated versus primary percutaneous coronary intervention in acute myocardial infarction: a meta-analysis

The authors concluded pre-hospital facilitated percutaneous coronary intervention (PCI) produced a higher rate of complete ST-segment resolution compared with primary PCI in ST-segment elevation myocardial infarction patients; as mortality was similar between groups, facilitated PCI had no advantage over primary PCI. Potential limitations in the review process and suboptimal trial quality mean that the reliability of these conclusions is unclear.

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

Version: 2010

Use of low-molecular-weight heparins in the management of acute coronary artery syndromes and percutaneous coronary intervention

This review compared the effectiveness of low molecular weight heparins (LMWHs) with unfractionated heparin for the treatment of acute coronary syndromes, and as an adjunct to percutaneous coronary intervention (PCI). The authors concluded that LMWHs could potentially replace unfractionated heparin as the antithrombotic treatment of choice across the spectrum of acute coronary syndromes, and may also be effective for PCI. Since the review methodology was unclear and could be subject to many biases, the authors' conclusions may not be robust.

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

Version: 2003

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

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

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

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