The review addressed a clear research question. Inclusion criteria for study design, interventions and outcomes were appropriate; participant criteria were broadly stated, although 'high-risk' was not defined. A range of relevant sources were searched to identify applicable studies, with no language restrictions, but no explicit attempts were made to identify grey literature. Although methods used for data extraction were appropriate, the methods used for selection of studies were not described, so reviewer error and bias during study selection could not be excluded.
The quality of the included trials was not assessed, so it was difficult to judge the reliability of the evidence presented. In the included trials, the definition of bleeding complications varied. The proportion of patients receiving downstream administration of glycoprotein IIb/IIIa inhibitors varied between trials and may have reflected differences in the risk profiles of the participants in the trials. Synthesis of the trials in meta-analyses and assessment of heterogeneity and publication bias were appropriate. The authors' conclusion reflected the evidence base, but the interpretation of the results was unclear as some participant details were not reported.
Lack of reporting on the quality of the included trials and potential bias in the review process mean that the authors' conclusions should be considered tentative