Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease

Citation
Df. Kong et al., Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease, CIRCULATION, 98(25), 1998, pp. 2829-2835
Citations number
33
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
98
Issue
25
Year of publication
1998
Pages
2829 - 2835
Database
ISI
SICI code
0009-7322(199812)98:25<2829:COOTAT>2.0.ZU;2-7
Abstract
Background-Several platelet glycoprotein (GP) IIb/IIIa receptor antagonists have been evaluated in clinical trials. We conducted a systematic overview (meta-analysis) to assess the effect of these compounds on death, myocardi al infarction (MI), and revascularization. Methods and Results-ORs were calculated for 16 randomized, controlled trial s of GP IIb/IIIa inhibitors. An empirical Bayesian random-effects model com bined the outcomes of 32135 patients. There was a significant mortality red uction by GP IIb/IIIa inhibitors at 48 to 96 hours, with an OR of 0.70 (95% CI, 0.51 to 0.96; P<0.03), equivalent to a reduction of 1 death per 1000 p atients treated. Mortality benefits at 30 days (OR, 0.87; 95% CI, 0.74 to 1 .02; P=0.08) and 6 months (OR, 0.97; 95% CI, 0.86 to 1.10; P=0.67) were not statistically significant. For the combined end point of death or MI, ther e was a highly significant (P<0.001) benefit for GP IIb/IIIa inhibitors at each time point. The 30-day OR was 0.76 (95% CI, 0.66 to 0.87), or 20 fewer events per 1000 patients treated. For the composite end point of death, MI , or revascularization, there was also a highly significant (P<0.001) benef it for GP IIb/IIIa inhibitors. At 30 days, the OR was 0.77 (95% CI, 0.68 to 0.86), or 30 fewer events per 1000 patients treated. The risk differences for death, death or MI, and composite outcomes were similar at 6 months, in dicating a sustained absolute improvement. Similar benefit was seen when tr ials were subgrouped by therapeutic indication (percutaneous intervention v ersus acute coronary syndromes). Conclusions-Application of this new therapeutic class to clinical practice promises substantial benefit for both indications.