Glycoprotein IIb/IIIa inhibitors for cardiogenic shock complicating acute myocardial infarction: a systematic review, meta-analysis, and meta-regression

12Citations
Citations of this article
11Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Background: Cardiogenic shock complicates 5–10% of myocardial infarction (MI) cases. Data about the benefit of glycoprotein IIb/IIIa inhibitors (GPI) in these patients is sparse and conflicting. Methods: We performed a systematic review, meta-analysis, and meta-regression of studies assessing the impact of GPI use in the setting of MI complicated cardiogenic shock on mortality, angiographic success, and bleeding events. We systematically searched for studies comparing GPI use as adjunctive treatment versus standard care in this setting. Random-effects meta-analysis and meta-regression were performed. Results: Seven studies with a total of 1216 patients (GPI group, 720 patients; standard care group, 496 patients) were included. GPI were associated with a 45% relative reduction in the odds of death at 30 days (pooled OR 0.55; 95% CI 0.35–0.85; I2 = 57%; P = 0.007) and a 49% reduction in the odds of death at 1 year (pooled OR 0.51; 95% CI 0.32–0.82; I2 = 58%; P = 0.005). Reduction in short-term mortality seemed to be more important before 2000, as this benefit disappears if only the more recent studies are analyzed. GPI were associated with a 2-fold increase in the probability of achieving TIMI 3 flow (pooled OR, 2.05; 95% CI 1.37–3.05; I2 = 37%, P = 0.0004). Major bleeding events were not increased with GPI therapy (pooled OR, 1.0; 95% CI 0.55–1.83; I2 = 1%, P = 0.99). Meta-regression identified that patients not receiving an intra-aortic balloon pump seemed to benefit the most from GPI use (Z = − 1.57, P = 0.005). Conclusion: GPI therapy as an adjunct to standard treatment in cardiogenic shock was associated with better outcomes, including both short- and long-term survival, without increasing the risk of bleeding.

References Powered by Scopus

Early revascularization in acute myocardial infarction complicated by cardiogenic shock

2635Citations
N/AReaders
Get full text

Contemporary Management of Cardiogenic Shock: A Scientific Statement from the American Heart Association

1345Citations
N/AReaders
Get full text

Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction

1190Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Factors Associated with Platelet Activation-Recent Pharmaceutical Approaches

16Citations
N/AReaders
Get full text

Antithrombotic and anticoagulation therapies in cardiogenic shock: a critical review of the published literature

13Citations
N/AReaders
Get full text

Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice

8Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Saleiro, C., Teixeira, R., De Campos, D., Lopes, J., Oliveiros, B., Costa, M., & Gonçalves, L. (2020, December 1). Glycoprotein IIb/IIIa inhibitors for cardiogenic shock complicating acute myocardial infarction: a systematic review, meta-analysis, and meta-regression. Journal of Intensive Care. BioMed Central Ltd. https://doi.org/10.1186/s40560-020-00502-y

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 3

100%

Readers' Discipline

Tooltip

Medicine and Dentistry 4

80%

Psychology 1

20%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 1

Save time finding and organizing research with Mendeley

Sign up for free