Abstract:
OBJECTIVES:We sought to evaluate the impact of intravenous antagonists of the platelet IIb/IIIa receptor on the survival of patients undergoing percutaneous coronary interventions (PCIs). BACKGROUND:Several trials have shown that intravenous antagonists of the platelet glycoprotein (GP) IIb/IIIa receptor reduce the incidence of myocardial infarction (MI) and composite cardiac outcomes (death, MI, or revascularization) in patients undergoing PCI. However, individual studies have not had adequate power to examine differences in mortality. METHODS:We performed a meta-analysis of 19 randomized, placebo-controlled trials (20 comparisons, n = 20,137). Death was the primary outcome. Secondary outcomes included MI, composite cardiac outcomes, and major bleeding. RESULTS:Mortality was significantly reduced at 30 days (risk ratio [RR] 0.69 [95% confidence interval [CI] 0.53 to 0.90]), at six months (RR 0.79 [95% CI 0.64 to 0.97]), and including longer follow-up (RR 0.79 [95% CI 0.66 to 0.94]), with no significant between-study heterogeneity. The relative risk reduction was largely similar in trials of patients with or without acute myocardial infarction (AMI), in trials continuing or discontinuing heparin after the procedure, and in trials using stents or another PCI as the intended primary procedure. Myocardial infarction and composite outcomes were significantly reduced (p < 0.001 for all) at 30 days and six months. Major bleeding was significantly increased only in trials where heparin infusion was continued after the procedure (RR 1.70 [95% CI 1.36 to 2.14]), although there was no excess bleeding when heparin was discontinued (RR 1.02 [95% CI 0.85 to 1.24]). CONCLUSIONS:In patients undergoing PCI, GP IIb/IIIa receptor antagonists confer a significant and sustained decrease (20% to 30%) in the risk of death.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Karvouni E,Katritsis DG,Ioannidis JPdoi
10.1016/s0735-1097(02)02666-9subject
Has Abstractpub_date
2003-01-01 00:00:00pages
26-32issue
1eissn
0735-1097issn
1558-3597pii
S0735109702026669journal_volume
41pub_type
杂志文章,meta分析abstract:BACKGROUND:Early in the prevention and treatment of bioprosthetic valve thrombosis (BPVT), anticoagulation is effective, but the long-term outcome after BPVT is unknown. OBJECTIVES:The goal of this study was to assess the long-term outcomes of patients with BPVT treated with anticoagulation. METHODS:This analysis was...
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abstract:BACKGROUND:It is unclear whether the overall effectiveness and safety of direct oral anticoagulants (DOACs) are consistent in patients with nonvalvular atrial fibrillation (AF) and extremely low body weight (<50 kg). OBJECTIVES:This study compared DOACs with warfarin in AF patients with low body weight. METHODS:Using...
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更新日期:2012-08-28 00:00:00
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更新日期:2011-02-08 00:00:00
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更新日期:2010-02-16 00:00:00
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更新日期:2015-04-07 00:00:00
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更新日期:2013-08-06 00:00:00
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更新日期:2003-04-16 00:00:00
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更新日期:2011-07-19 00:00:00