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Table 2 Studies included in the analysis and main findings

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

Study

Design

No. patients

GPI (n)

Age (GPI vs Standard care)

Outcomes

Giri et al. [11]

Nonrandomized, prospective, observational

(1995–1999)

114

54

66 ± 14 vs 67 ± 13

• GPI significantly improved final TIMI flow.

• At 30-day follow-up, the composite event rate of death, myocardial reinfarction, and target vessel revascularization were better in the GPI group (31% vs 63%; P = 0.002).

• Lower mortality (22% vs 44%; p = 0.02) and recurrent infarction rates (0% vs 10%; p = 0.05) in the GPI group.

• Combination of abciximab and stents was synergistic and resulted in improvement of all components of the composite end point.

Chan et al. [12]

Nonrandomized, prospective, observational

(1993–2000)

96

45

67 ± 11 vs 64 ± 14 vs 63 ± 16 vs 68 ± 9

(Stent+abciximab vs stent only vs PCI + abciximab vs PCI alone)

• 2.5 years of follow-up, the mortality rates for stent plus abciximab, stent only, PCI plus abciximab, and PCI alone were 33%, 43%, 61%, and 68% (P = 0.028).

• Stent and abciximab resulted in higher TIMI 3 flow rates (85% vs 65%, P = 0.048).

• A trend of mortality benefit with abciximab was seen at 30 months (HR 0.74, 95% CI 0.36–1.11, P = 0.11).

Antoniucci et al. [13]

Nonrandomized, prospective, observational

(1999–2001)

77

44

66 ± 12 vs 71 ± 12

• 1-month overall mortality rate was lower in the abciximab (18% vs 42%, P < 0.020).

• No differences between groups in reinfarction and target vessel revascularization rates.

• Multivariate analysis showed that abciximab therapy was the only variable independently related to 1-month mortality (OR 0.36; 95% CI 0.15–0.86, P < 0.021).

PRAGUE-7

Tousek et al. [14]

Randomized control trial

(2006–2009)

80

40

64 ± 14 vs 68 ± 11

• The 30-day combined outcome of death/reinfarction/stroke/new severe renal failure occurred in 42.5% in the group randomized to abciximab vs 27.5% in the standard therapy group (P = 0.24).

• No differences were found in TIMI-flow after PCI or major bleeding.

Bernat et al. [15]

Nonrandomized, observational

(2006–2010)

179

80

NA

• The use of GPI (HR 0.63, 95% CI 0.40–0.96, P = 0.032) was associated with a better outcome at a-year in multivariable analysis.

Felice et al. [16]

Nonrandomized, observational

(2002–2011)

410

287

67 ± 12 vs 73 ± 12

• No difference at a 1-year survival rates (42.8% vs 51.6%, P = 0.56) in patients treated without vs. with abciximab.

• Age, oro-tracheal intubation, post-PCI TIMI flow grade 0–1 but not abciximab use (HR, 1.08; 95% CI 0.70–1.60, P = 0.60) were independent predictors of death at 1-year follow-up.

Kanic et al. [17]

(2009–2014)

261

170

66.7 ± 12.5 vs 64.9 ± 12.9

• All-cause mortality was similar between groups (46.5% vs 54.9%) at 30 days; (53.5% vs. 61.1%) at 1 year.

• The adjunctive usage of GPI (OR 0.41; 95%CI 0.20–0.84; P = 0.015), and novel P2Y12 inhibitors were associated with a better 30-day survival.

• Better 1-year survival was independently predicted by GPI (HR 0.62; 95%CI 0.39–0.97; P = 0.037), novel P2Y12 inhibitors, age, left main PCI, TIMI 0/1 pre-PCI, and major bleeding.

  1. GPI glycoprotein IIb/IIIa inhibitors, TIMI thrombolysis in myocardial infarction, PCI percutaneous coronary intervention, NA not applicable, HR hazard ratio, OR odds ratio, CI confidence intervals