Clinical Outcomes of Therapeutic Agents That Block the Platelet Glycoprotein IIb/IIIa Integrin in Ischemic Heart Disease

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, myocardial infarction (MI), and revascularization. Methods and Results —ORs were calculated for 16 randomized, controlled trials of GP IIb/IIIa inhibitors. An empirical Bayesian random-effects model combined the outcomes of 32 135 patients. There was a significant mortality reduction by GP IIb/IIIa inhibitors at 48 to 96 hours, with an OR of 0.70 (95% CI, 0.51 to 0.96; P 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, there was a highly significant ( P P Conclusions —Application of this new therapeutic class to clinical practice promises substantial benefit for both indications.