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

David L. Brown, Cathy S.J. Fann, Chee Jenz Chang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)253-258
Number of pages6
JournalCardiovascular Drugs and Therapy
Volume14
Issue number3
DOIs
StatePublished - Jul 22 2000

Keywords

  • Meta-analysis
  • Myocardial infarction
  • Platelet aggregation inhibitors
  • Unstable angina

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