Key result
Triple antiplatelet therapy based on intravenous GP IIb/IIIa inhibitors significantly reduced composite vascular events compared to dual therapy in patients with NSTE-ACS (OR 0.69) and STEMI (OR 0.39).
Why the study?
Does triple antiplatelet therapy reduce recurrent vascular events in patients with ischaemic heart disease compared to dual antiplatelet therapy?
Population
25 completed randomized trials involving 17,383 patients with ischaemic heart disease (IHD)
Comparison
Triple antiplatelet therapy involving… vs Dual antiplatelet therapy (aspirin-based therapy)
Design
Meta-analysis
Authors
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Supports GP IIb/IIIa triple therapy in ACS despite bleeding risk; confirms event reduction but leaves elective PCI unsupported.
Meta-Analysis (n=17,383)
Does triple antiplatelet therapy reduce recurrent vascular events in patients with ischaemic heart disease compared to dual antiplatelet therapy?
Effect estimate: OR 0.69 (95% CI 0.55-0.86)
Absolute Event Rate: 10.9% vs 15.7%
Triple antiplatelet therapy with IV GP IIb/IIIa inhibitors reduces vascular events in ACS patients but increases bleeding, with no benefit and increased harm in elective PCI.
Geeganage et al. (2010) conducted a meta-analysis in Ischaemic heart disease (NSTE-ACS, STEMI, elective PCI) (n=17,383). Triple antiplatelet therapy (intravenous GP IIb/IIIa inhibitor, clopidogrel, or cilostazol added to dual therapy) vs. Dual antiplatelet therapy was evaluated on Composite vascular events (non-fatal stroke, non-fatal myocardial infarction, or death) in NSTE-ACS patients treated with GP IIb/IIIa inhibitors (OR 0.69, 95% CI 0.55-0.86). Triple antiplatelet therapy based on intravenous GP IIb/IIIa inhibitors significantly reduced composite vascular events compared to dual therapy in patients with NSTE-ACS (OR 0.69) and STEMI (OR 0.39).
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