Six RCTs were included in the review (1,429 patients). Of those, four trials reported clinical outcomes after percutaneous coronary intervention. Longest reported length of follow-up for clinical outcomes was 30 days for two studies and six months for the other two trials.
The odds of a major adverse cardiovascular event were significantly lower for patients who received tirofiban compared to control (OR 0.5, 95% CI 0.26 to 0.94; four trials). There was evidence of some heterogeneity (Ι²=39%). An analysis of three studies that reported major adverse cardiovascular events at 30 days reported a difference favouring tirofiban that was not statistically significant.
There was a difference in mortality favouring tirofiban that was not statistically significant using a random-effects analysis, but was significant using a fixed-effect analysis (OR 0.43; 95% CI 0.22 to 0.81). Both analyses included three trials and showed evidence of some heterogeneity (Ι²=32%).
There was no significant difference in major bleeding between the groups, but a non significant trend toward increased bleeding (any bleeding) with tirofiban was found.
Corrected thrombolysis in myocardial infarction frame count was significantly reduced with tirofiban (mean difference -8.48; 95% CI -12.62 to -4.34; four trials; Ι²=80%). The odds of reinfarction and revascularisation were not significantly different between the two groups. Other angiographic outcomes were reported in the review.