percutaneous coronary intervention

systematic review meta-analysis network meta-analysis

Select pre treatment for PCIradial accessthrombectomystatinsanticoagulantantiplatelets drugantithromboticsanti inflammatory drugsanti-anginal drugsbioresorbable vascular scaffoldproton-pump inhibitorsrestenosis prevention All type of patientMI patients undergoing primary PCIuncoded clinical condition ***Acute myocardial infarctionPCI with stent placementstable and unstable ACS       6 months DAPTantiplatelet drugsbioresorbable vascular scaffoldcalcium-channel blockersCatheter aspiration devicescompetitive PAR-1 antagonistcomplement inhibitordirect thrombin inhibitordual antiplatelet therapyembolic protection devicesGP IIaIIIb inhibitorsLow Molecular Weight HeparinMechanical thrombectomy devicesnicorandilP2Y12 receptor antagonistpretreatment with statinprolonged dual antiplatelet therapyproton-pump inhibitorsradial accessreversible ADP receptor antagoniststatinsthienopyridinetriple antiplatelet atorvastatinfluvastatinpravastatinamlodipinediltiazemnifedipinenisoldipineverapamilabciximabaspirinbivalirudincangrelorcilostazolclopidogreldalteparindipyridamoldiverselinogrelenoxaparineptifibatidefondaparinuxnicorandilpexelizumabprasugrelreviparinrosiglitazonesulotrobanticlopidinetirofiban vs control or placebovs conventional PCIvs femoral accessvs heparinvs heparin + anti Gp2b3avs placebovs placebo or controlvs anticoagulant + antiplateletvs antiplatelet drugsvs clopidogrelvs PPIvs short antiplatelet drugvs standard clopidogrel      

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Group by Group by... nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition MA  in first nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in second nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in third	Description Synopsis Comparison Treatments Patients Characteristics Method Risk of bias References None Tools Indexation					Results Global trial result Main results All results All result tag NCT results	All cause death (70)MACE (63)Major bleeding (31)myocardial infarction (fatal and non fatal) (23)stroke (fatal and non fatal) (18)reinfarction (18)Non fatal MI (16)Bleeding (14)stent thrombosis (14)all cause death, MI, stroke (12)Unplanned revascularisation for ischaemia (10)Vascular events (9)Vascular death (8)Non vascular death (7)cardiovascular events (7)Cardiovascular death (7)Non fatal stroke (6)death, MI, unplanned revascularization (6)Minor bleeding (6)Revascularization (5)net benefit (3)Cardiovascular death/MI/stent thrombosis (3)GUSTO severe/moderate bleeding (3)any bleedings (3)cardiac death (2)Stent thrombosis (any, end of follow up) (2)MI (CK-MB >3x ULN at 6 and 12 hours after PCI) (1)MI (troponin I >3x ULN at 6 and 12 hours after PCI) (1)Serious infection (1) Options Numeric bar chart forest plot medians
Trial	Studied trt	Control trt	patients	tags	ROB	Trial result	All cause death	MACE
anti inflammatory drugs
pexelizumab
APEX-AMI, 2007          NCT	pexelizumab	placebo			Low risk of bias	negative
anti-anginal drugs
nicorandil
Nishimura, 2009	nicorandil	control			Risk of bias	-
anticoagulant
not classified
Brieger	enoxaparin	UFH				-
bivalirudin
REPLACE-2, 2003	bivalirudin	heparin + GP2b3a inhibitors			Low risk of bias	-
HORIZONS-AMI (Stone), 2008        NCT	bivalirudin	heparin + GP2b3a inhibitors			Risk of bias	suggesting
ACUITY (Stone) (bivalirudin alone), 2006      NCT	bivalirudin	heparin + GP2b3a inhibitors			Risk of bias	-
Kleiman, 2002	bivalirudin + eptifibatide	heparin + GP2b3a inhibitors			Exploratory	-
ISAR-REACT 3, 2008    NCT	bivalirudin	UFH			Low risk of bias	-
REPLACE-1, 2004	bivalirudin	UFH			Exploratory	negative
BAT (Bittl), 1995	bivalirudin	UFH			Low risk of bias	suggesting
ARMYDA BIVALVE	bivalirudin	UFH				-
NAPLES (Tavano), 2009	bivalirudin	UFH plus tirofiban			Risk of bias	suggesting
dalteparin
Natarajan (without antiGp2b3a), 2003	dalteparin	UFH				-
Natarajan (+ antiGp2b3a), 2003	dalteparin	UFH + anti Gp2b3a				-
enoxaparin
STEEPLE, 2006      NCT	enoxaparin	UFH			Risk of bias	-
Rabah, 1999	enoxaparin	UFH			Exploratory	negative
CRUISE, 2003	enoxaparin	UFH			Exploratory	negative
Galeote, 2001	enoxaparin	UFH				negative
Dudek, 2000	enoxaparin	UFH				negative
Dudek b (enox alone), 2000	enoxaparin	UFH				-
Drozd, 2001	enoxaparin	UFH				negative
ATOLL, 2010	enoxaparin	UFH			Risk of bias	-
Dubek b (+abciximal), 2001	enoxaparin+abciximab	UFH				-
reviparin
REDUCE, 1996	reviparin	UFH			Low risk of bias	suggesting
antiplatelets drug
not classified
DECLARE-LONG II , 2011						-
OPTIMIZE, 2013      NCT	3 months DAPT	12 months DAPT			Risk of bias	-
EXCELLENT, 2011      NCT	6-month dual antiplatelet therapy	12 months dual antiplatelet				negative
PRODIGY, 2011      NCT	24 months of dual antiplatelet treatment	6 months dual antiplatelet				negative
WOEST    NCT	triple therapy	dual antiplatelet therapy				-
RESET    NCT	Endeavor stent and three months of DAPT	standard 12-month DAPT and other DES				negative
DES-LATE, 2010    NCT	prolonged dual antiplatelet therapy	12 months dual antiplatelet			Risk of bias	negative
ISAR-SAFE, 2009      NCT	12 months dual antiplatelet	6 months dual antiplatelet			Low risk of bias	-
CILON-T, 2010	triple antiplatelet	dual antiplatelet therapy			Exploratory	negative
cilostazol
Kunishima, 1997	cilostazol	aspirin				negative
Sekiya, 1998	cilostazol + aspirin	aspirin				negative
Kozuma, 2001	cilostazol + aspirin	ticlopidine + aspirin				negative
Ochiai, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Park, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Yoon, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Kamishirado, 2002	cilostazol + aspirin	ticlopidine + aspirin				negative
clopidogrel
REAL-LATE, ZEST-LATE, 2010      NCT	clopidogrel+aspirin	aspirin				negative
GRAVITAS, 2011      NCT	high-dose clopidogrel	normal-dose clopidogrel			Risk of bias	negative
Müller, 2000	clopidogrel + aspirin	ticlopidine + aspirin				negative
CLASSICS, 2000	clopidogrel + aspirin	ticlopidine + aspirin				negative
TOPPS, 2001	clopidogrel + aspirin	ticlopidine + aspirin				negative
Piamsomboon, 2001	clopidogrel + aspirin	ticlopidine + aspirin				negative
ticlopidine
STARS (vs aspirin), 1998	ticlopidine + aspirin	aspirin				suggesting
Hall, 1996	ticlopidine + aspirin	aspirin				negative
FANTASTIC, 1998	ticlopidine + aspirin	coumadin + aspirin				negative
ISAR, 1996	ticlopidine + aspirin	coumadin + aspirin				suggesting
Foussas, 2000	ticlopidine + aspirin	coumadin + aspirin				suggesting
MATTIS, 1998	ticlopidine + aspirin	coumadin + aspirin				negative
STARS (vs coumadin+asp), 1998	ticlopidine + aspirin	coumadin + aspirin				suggesting
antithrombotics
not classified
EPIC (without infusion), 1991						-
IMPACT (12h), 1993						-
IMPACT-II (0.75µg), 1994						-
EXCELLENT, 2011      NCT	6-month dual antiplatelet therapy	12 months dual antiplatelet				negative
Finci, 1989		placebo				negative
Oriol, 1995		placebo				negative
TRA-PCI, 2009      NCT	SCH 530348	placebo			Low risk of bias	-
Brieger	enoxaparin	UFH				-
DES-LATE, 2010    NCT	prolonged dual antiplatelet therapy	12 months dual antiplatelet			Risk of bias	negative
ISAR-SAFE, 2009      NCT	12 months dual antiplatelet	6 months dual antiplatelet			Low risk of bias	-
CILON-T, 2010	triple antiplatelet	dual antiplatelet therapy			Exploratory	negative
abciximab
RAPPORT, 1998	Abciximab	placebo				-
ADMIRAL, 2001	Abciximab	placebo				-
CADILLAC, 2002	Abciximab	placebo				-
EPIC (with infusion), 1994	Abciximab	placebo				-
EPILOG, 1997	Abciximab	placebo				-
EPISTENT, 1998	Abciximab	placebo				-
CAPTURE, 1997	Abciximab	placebo				-
ERASER, 1999	Abciximab	placebo				-
Petronio, 2002	Abciximab	placebo				-
Simoons, 1994	Abciximab	placebo				-
Kini, 2001	Abciximab	placebo				-
Tamburino, 2002	Abciximab	placebo				-
ISAR-2, 2000	Abciximab	placebo				-
aspirin
Taylor (Perth), 1991	aspirin	placebo			Low risk of bias	negative
M-HEART II (aspirin), 1995	aspirin	placebo			Low risk of bias	negative
bivalirudin
REPLACE-2, 2003	bivalirudin	heparin + GP2b3a inhibitors			Low risk of bias	-
HORIZONS-AMI (Stone), 2008        NCT	bivalirudin	heparin + GP2b3a inhibitors			Risk of bias	suggesting
ACUITY (Stone) (bivalirudin alone), 2006      NCT	bivalirudin	heparin + GP2b3a inhibitors			Risk of bias	-
Kleiman, 2002	bivalirudin + eptifibatide	heparin + GP2b3a inhibitors			Exploratory	-
ISAR-REACT 3, 2008    NCT	bivalirudin	UFH			Low risk of bias	-
REPLACE-1, 2004	bivalirudin	UFH			Exploratory	negative
BAT (Bittl), 1995	bivalirudin	UFH			Low risk of bias	suggesting
ARMYDA BIVALVE	bivalirudin	UFH				-
NAPLES (Tavano), 2009	bivalirudin	UFH plus tirofiban			Risk of bias	suggesting
cangrelor
CHAMPION PHOENIX, 2013        NCT	cangrelor	clopidogrel			Low risk of bias	suggesting
CHAMPION-PCI, 2009      NCT	cangrelor up front	clopidogrel up front			Low risk of bias	negative
CHAMPION-PLATFORM, 2009    NCT	cangrelor up front	delayed clopidogrel			Low risk of bias	negative
cilostazol
Kunishima, 1997	cilostazol	aspirin				negative
Sekiya, 1998	cilostazol + aspirin	aspirin				negative
Kozuma, 2001	cilostazol + aspirin	ticlopidine + aspirin				negative
Ochiai, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Park, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Yoon, 1999	cilostazol + aspirin	ticlopidine + aspirin				negative
Kamishirado, 2002	cilostazol + aspirin	ticlopidine + aspirin				negative
clopidogrel
GRAVITAS, 2011      NCT	high-dose clopidogrel	normal-dose clopidogrel			Risk of bias	negative
Müller, 2000	clopidogrel + aspirin	ticlopidine + aspirin				negative
CLASSICS, 2000	clopidogrel + aspirin	ticlopidine + aspirin				negative
TOPPS, 2001	clopidogrel + aspirin	ticlopidine + aspirin				negative
Piamsomboon, 2001	clopidogrel + aspirin	ticlopidine + aspirin				negative
dalteparin
Natarajan (without antiGp2b3a), 2003	dalteparin	UFH				-
Natarajan (+ antiGp2b3a), 2003	dalteparin	UFH + anti Gp2b3a				-
dipyridamol
Schwartz (Toronto), 1988	aspirin + dipyridamol	placebo			Low risk of bias	suggesting
White (aspirin+dipiridamol), 1991	aspirin + dipyridamol	placebo				negative
Nye (Dunedin), 1990	aspirin + dipyridamol	placebo				negative
Mayo-PTCA, 1989	aspirin + dipyridamol	placebo				negative
elinogrel
INNOVATE PCI          NCT	elinogrel	clopidogrel				-
enoxaparin
STEEPLE, 2006      NCT	enoxaparin	UFH			Risk of bias	-
Rabah, 1999	enoxaparin	UFH			Exploratory	negative
CRUISE, 2003	enoxaparin	UFH			Exploratory	negative
Galeote, 2001	enoxaparin	UFH				negative
Dudek, 2000	enoxaparin	UFH				negative
Dudek b (enox alone), 2000	enoxaparin	UFH				-
Drozd, 2001	enoxaparin	UFH				negative
ATOLL, 2010	enoxaparin	UFH			Risk of bias	-
Dubek b (+abciximal), 2001	enoxaparin+abciximab	UFH				-
eptifibatide
IMPACT (4h), 1995	Eptifibatide	placebo				-
IMPACT-II (0.5µg), 1997	Eptifibatide	placebo				-
ESPRIT, 2000	Eptifibatide	placebo				-
Harrington, 1995	Eptifibatide	placebo				-
prasugrel
TRITOM TIMI 38 (PCI subgroup), 2009	prasugrel	clopidogrel				-
JUMBO-TIMI 26, 2005	prasugrel	clopidogrel			Low risk of bias	negative
reviparin
REDUCE, 1996	reviparin	UFH			Low risk of bias	suggesting
sulotroban
M-HEART II (sulotroban), 1995	sulotroban	placebo			Low risk of bias	-
ticlopidine
TACT, 1990	ticlopidine	placebo				negative
White (ticlopidine), 1991	ticlopidine	placebo				-
STARS (vs aspirin), 1998	ticlopidine + aspirin	aspirin				suggesting
Hall, 1996	ticlopidine + aspirin	aspirin				negative
FANTASTIC, 1998	ticlopidine + aspirin	coumadin + aspirin				negative
ISAR, 1996	ticlopidine + aspirin	coumadin + aspirin				suggesting
Foussas, 2000	ticlopidine + aspirin	coumadin + aspirin				suggesting
MATTIS, 1998	ticlopidine + aspirin	coumadin + aspirin				negative
STARS (vs coumadin+asp), 1998	ticlopidine + aspirin	coumadin + aspirin				suggesting
tirofiban
RESTORE, 1997	Tirofiban	placebo				-
Kereiakis, 1996	Tirofiban	placebo				-
bioresorbable vascular scaffold
not classified
ABSORB III, 2015    NCT						-
LEADERS FREE      NCT						-
BIOFLOW-V    NCT	biodegradable polymer sirolimus-eluting stent	durable polymer everolimus-eluting stent				-
ABSORB II      NCT	(Absorb, Abbott Vascular,	everolimus-eluting metallic stent				-
pre treatment for PCI
cangrelor
CHAMPION-PCI, 2009      NCT	cangrelor up front	clopidogrel up front			Low risk of bias	negative
proton-pump inhibitors
not classified
COGENT, 2009    NCT	omeprazole	placebo			Low risk of bias	suggesting
OCLA, 2008    NCT	omeprazole	placebo			Low risk of bias	-
PACA, 2009	pantoprazole	omeprazole				-
radial access
not classified
Grinfeld, 1996	radial	femoral				-
Mann , 1996	radial	femoral				-
ACCESS , 1997	radial	femoral				negative
BRAFE , 1997	radial	femoral				negative
Cooper , 1999	radial	femoral				negative
Mann , 1998	radial	femoral				negative
Monsegu , 2000	radial	femoral				-
CARAFE , 2001	radial	femoral				-
Gorge and Kirstein, 2001	radial	femoral				negative
Moriyama , 2002	radial	femoral				-
TEMPURA , 2003	radial	femoral				negative
OCTOPLUS , 2004	radial	femoral				suggesting
Tian , 2003	radial	femoral				-
Reddy , 2004	radial	femoral				-
RADIAL AMI , 2005	radial	femoral				negative
Achenbach , 2005	radial	femoral				negative
OUTCLAS , 2005	radial	femoral				negative
FARMI , 2007	radial	femoral				negative
Lange and von Boetticher, 2006	radial	femoral				-
RADIAMI , 2007	radial	femoral				negative
Bodi, 2008	radial	femoral				suggesting
Li , 2007	radial	femoral				-
Vazquez-Rodriguez, 2004	radial	femoral				negative
restenosis prevention
amlodipine
Jorgensen (NICOLE), 2001	amlodipine	placebo			Low risk of bias	suggesting
diltiazem
Corcos, 1985	diltiazem	control				negative
O’Keefe, 1991	diltiazem	placebo			Low risk of bias	negative
Unverdorben, 1996	diltiazem	placebo			Low risk of bias	suggesting
nifedipine
Whitworth, 1986	nifedipine	placebo			Low risk of bias	negative
nisoldipine
Dens (CAPARES), 2000	nisoldipine	placebo			Low risk of bias	suggesting
verapamil
Hoberg, 1994	verapamil	placebo			Low risk of bias	negative
statins
not classified
Briguori, 2004	various statins	placebo				suggesting
atorvastatin
NAPLES II (Briguori), 2009	atorvastatin	control				suggesting
ARMYDA, 2004	atorvastatin	placebo			Low risk of bias	suggesting
ARMYDA-RECAPTURE, 2009	atorvastatin reload	placebo			Low risk of bias	suggesting
GAIN, 2001	atorvastatin	usual care				negative
fluvastatin
FLARE, 1999	fluvastatin	placebo			Low risk of bias	negative
LIPS, 2002	fluvastatin	placebo			Low risk of bias	negative
pravastatin
PREDICT, 1997	pravastatin	placebo			Low risk of bias	negative
thrombectomy
not classified
DIPLOMATE, 2004	Angioguard	conventional PCI				negative
Wang, 2003	Angioguard	conventional PCI				-
AiMI, 2006	AngioJet	conventional PCI				negative
Florence, 2004	AngioJet	conventional PCI				negative
JETSTENT, 2010	AnjioJet	conventional PCI			Exploratory	negative
TAPAS, 2008	Export	conventional PCI				suggesting
Noel, 2005	Export	conventional PCI				negative
EXPIRA, 2005	Export	conventional PCI				negative
Export (Chevalier), 2008	Export	conventional PCI				suggesting
Lipiecki, 2009	Export	conventional PCI				-
UpFlow MI, 2007	FilterWire	conventional PCI				negative
PROMISE, 2005	FilterWire	conventional PCI				-
DEDICATION, 2008	FilterWireg	conventional PCI				negative
Tahk, 2008	GuardWire	conventional PCI				suggesting
MICADO, 2007	GuardWire	conventional PCI				negative
Ochala, 2007	GuardWire	conventional PCI				negative
EMERALD, 2005	GuardWire	conventional PCI				negative
ASPARAGUS, 2008	Guardwire	conventional PCI				negative
Nanasato, 2004	Guardwire	conventional PCI				-
DEAR-MI, 2006      NCT	Pronto	conventional PCI				suggesting
Kaltoft, 2006	Rescue	conventional PCI				negative
Dudek, 2004	Rescue	conventional PCI				suggesting
NONSTOP, 2004	Rescue	conventional PCI				-
PREMIAR, 2007	SpideRX	conventional PCI				negative
TROPHI	thrombectomy	conventional PCI				-
MUSTELLA	thrombectomy	conventional PCI				-
Ciszewski, 2011	thrombectomy	conventional PCI				-
Liistro, 2009	thrombectomy	conventional PCI				-
INFUSE AMI, 2013	thrombectomy	conventional PCI				-
Chao, 2008	thrombectomy	conventional PCI				-
VAMPIRE, 2004	TVAC	conventional PCI				suggesting
X AMINE ST, 2005	X-sizer	conventional PCI				suggesting
Napodano, 2003	X-sizer	conventional PCI				suggesting
Beran, 2002	X-sizer	conventional PCI				suggesting
TASTE (Fröbert), 2013      NCT	thrombectomy	PCI only				-
TOTAL, 2015      NCT	thrombectomy	PCI only	aaa			negative
divers
De Luca, 2006	Diver	conventional PCI				suggesting
REMEDIA, 2005	Diver	conventional PCI				suggesting
PIHRATE, 2004	Diver	conventional PCI				negative
Sardella, 2005	Diver	conventional PCI				-