TY - JOUR
T1 - Effect of glycoprotein IIb/IIIa inhibitors on the individual components of composite endpoints used in clinical trials of unstable angina and non-Q-wave myocardial infarction
AU - Brown, David L.
AU - Fann, Cathy S.J.
AU - Chang, Chee Jen
PY - 2000/6/26
Y1 - 2000/6/26
N2 - Inhibitors of the platelet glycoprotein (GP) IIb/IIa receptor complex have recently been approved for the treatment of patients with unstable angina and non-Q-wave myocardial infarction (MI). We performed a meta-analysis to ascertain the effect of these agents on the individual endpoints of death, myocardial infarction, refractory ischemia, and major bleeding after 30 days of follow-up. Five randomized, placebo-controlled trials involving 17,255 patients were identified. The odds ratios for each of the endpoints in each trial were calculated and combined using a fixed-effects model. There was no significant reduction in death (OR, 0.87; 95% CI, 0.73-1.03; P = 0.1), myocardial infarction (OR, 0.91; 95% CI, 0.82-1.004; P = 0.06), or refractory ischemia (OR, 0.92; 95% CI, 0.78-1.1; P = 0.36) in patients treated with GP IIb/IIIa inhibitors. There was a significant increase in major bleeding following treatment with GP IIb/IIIa inhibitors (OR, 1.2; 95% CI, 1.06-1.4; P = 0.005). When used to treat unstable angina and non-Q-wave MI, this new class of agents appears to be associated with minimal clinical benefit and an increase in major bleeding complications.
AB - Inhibitors of the platelet glycoprotein (GP) IIb/IIa receptor complex have recently been approved for the treatment of patients with unstable angina and non-Q-wave myocardial infarction (MI). We performed a meta-analysis to ascertain the effect of these agents on the individual endpoints of death, myocardial infarction, refractory ischemia, and major bleeding after 30 days of follow-up. Five randomized, placebo-controlled trials involving 17,255 patients were identified. The odds ratios for each of the endpoints in each trial were calculated and combined using a fixed-effects model. There was no significant reduction in death (OR, 0.87; 95% CI, 0.73-1.03; P = 0.1), myocardial infarction (OR, 0.91; 95% CI, 0.82-1.004; P = 0.06), or refractory ischemia (OR, 0.92; 95% CI, 0.78-1.1; P = 0.36) in patients treated with GP IIb/IIIa inhibitors. There was a significant increase in major bleeding following treatment with GP IIb/IIIa inhibitors (OR, 1.2; 95% CI, 1.06-1.4; P = 0.005). When used to treat unstable angina and non-Q-wave MI, this new class of agents appears to be associated with minimal clinical benefit and an increase in major bleeding complications.
KW - Meta-analysis
KW - Myocardial infarction
KW - Platelet aggregation inhibitors
KW - Unstable angina
UR - http://www.scopus.com/inward/record.url?scp=0033937362&partnerID=8YFLogxK
U2 - 10.1023/A:1007874422754
DO - 10.1023/A:1007874422754
M3 - 文章
C2 - 10935147
AN - SCOPUS:0033937362
SN - 0920-3206
VL - 14
SP - 253
EP - 258
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
IS - 3
ER -