Document Detail


Differential treatment benefit of platelet glycoprotein IIb/IIIa inhibition with percutaneous coronary intervention versus medical therapy for acute coronary syndromes: exploration of methods.
MedLine Citation:
PMID:  14769687     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although many believe that platelet glycoprotein IIb/IIIa inhibitors should be used only in acute coronary syndrome patients undergoing percutaneous coronary intervention, supporting data from randomized clinical trials are tenuous. The assumption that these agents are useful only in conjunction with percutaneous coronary intervention is based primarily on inappropriate subgroup analyses performed across the glycoprotein IIb/IIIa inhibitor trials. METHODS AND RESULTS: We describe the problems with these analytical techniques and demonstrate that different approaches to the question can result in opposing answers. CONCLUSIONS: Clinical-practice decisions and practice guidelines should be based on overall trial results and not analyses of post-randomization subgroups.
Authors:
Karen S Pieper; Anastasios A Tsiatis; Marie Davidian; Vic Hasselblad; Neal S Kleiman; Eric Boersma; Wei-Ching Chang; Jeffrey Griffin; Paul W Armstrong; Robert M Califf; Robert A Harrington
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  109     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-10     Completed Date:  2004-04-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  641-6     Citation Subset:  AIM; IM    
Affiliation:
Duke Clinical Research Institute and Department of Medicine, Duke University Medical Center, Durham, NC 27715, USA. karen.pieper@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Combined Modality Therapy
Coronary Disease / drug therapy*,  surgery*
Female
Humans
Male
Middle Aged
Myocardial Revascularization*
Patient Selection
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Randomized Controlled Trials as Topic
Research Design
Syndrome
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Glycoprotein GPIIb-IIIa Complex

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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