Eight trials were included (1,577 patients, 58 to 507). Reporting of study designs had multiple gaps. Only four of the eight trials reported adequate randomisation. Two trials reported adequate allocation concealment methods. Five studies were unclear about whether they used blinding. Six out of eight studies had no loss to follow-up.
There were no statistically significant differences in incidence of 30-day mortality (RR 1.69, 95% CI 0.69 to 4.13; five trials) and re-myocardial infarction (RR 0.71, 95% CI 0.21 to 2.35; five trials) between early and late administration of tirofiban. There were no differences in post-procedural TIMI flow grade 3 (eight trials) and Corrected TIMI Frame Count (three trials) between the two groups. No significant difference was observed in hospital minor bleeding (three trials) and hospital (five trials) and 30-day major bleeding (four trials) between the two groups. There was no evidence of significant heterogeneity except for Corrected TIMI Frame Count (51%).