Six RCTs were included (n=2,684 patients).
Adjunctive Gp IIb-IIIa inhibitors plus reduced lytic therapy was associated with a statistically significant improvement in preprocedural TIMI 3 flow (44.3% versus 15.2%, OR 4.14, 95% CI 3.44 to 4.99) compared to compared adjunctive Gp IIb-IIIa inhibitors alone. There was no significant difference in postprocedural TIMI 3 flow (91.5% versus 91.2%). Significant heterogeneity was found for preprocedural (p<0.0001) but not postprocedural TIMI 3 flow.
There was no significant difference between treatments in 30-day mortality (4.2% versus 4.6%) or 30-day reinfarction (1.3% versus 1.3%).
Adjunctive Gp IIb-IIIa inhibitors plus reduced lytic therapy was associated with a statistically significant increase in risk of bleeding complications (5.8% versus 3.9%, OR 1.50, 95% CI 1.04 to 2.18).
No significant heterogeneity was found for mortality, reinfarction or bleeding outcomes.
There was no evidence of publication bias from Egger’s test.