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antithrombotics in percutaneous coronary intervention for all type of patients, clinical trials results

Abciximab versus placebo
ADMIRAL, 2001
loading dose 250µg/kg infusion 0.125µg/kg/min for 12h
versus
Primary PCI
CADILLAC, 2002
loading dose 250µg/kg infusion 0.125µg/kg/min for 12h
versus
Primary PCI
RAPPORT, 1998
loading dose 250µg/kg infusion 0.125µg/kg/min for 12h
versus
Primary PTCA <
EPIC (with infusion), 1994
loading dose 250µg/kg infusion 10µg/min for 12h
versus
High risk for abrupt closurebitm
EPILOG, 1997
loading dose 250µg/kg infusion 0.125µg/kg/min (max 10µg) for 12h
versus
Elective or urgent PCIe
EPISTENT, 1998
loading dose 250µg/kg infusion 0.125µg/kg/min for 12h
versus
Elective or urgent PCI
CAPTURE, 1997
loading dose 250µg/kg infusion 10µg/min for 18-24h
versus
ERASER, 1999
loading dose µg/kg infusion µg/min for h
versus
Petronio, 2002
loading dose µg/kg infusion µg/min for h
versus
Simoons, 1994
loading dose µg/kg infusion µg/min for h
versus
Kini, 2001
loading dose µg/kg infusion µg/min for h
versus
Tamburino, 2002
loading dose µg/kg infusion µg/min for h
versus
ISAR-2, 2000
loading dose 250µg/kg infusion 10µg/min for 12h
versus
PCI <48 h after MI
aspirin versus placebo
Taylor (Perth), 1991
aspirin, 100 mg/day after 2 weeks
versus
placebo
patients aged less than 70 years without acute infarction undergoing PTCAdouble blind
Follow-up duration: 6m
M-HEART II (aspirin), 1995
aspirin 325 mg daily
versus
placebo
patients undergoing PTCAdouble blind
Follow-up duration: 6m
aspirin + dipyridamol versus placebo
Schwartz (Toronto), 1988
aspirin 990 + D225 (H)
versus
placebo
double blind
Follow-up duration: 6m
Canada
White (aspirin+dipiridamol), 1991
ticlopidine 500, aspirin 650 + D225
versus

Follow-up duration: 6m
Nye (Dunedin), 1990
aspirin 300 + D225
versus
placebo
NA
Follow-up duration: 12m
Mayo-PTCA, 1989
aspirin 975 + D225
versus

Follow-up duration: 48h
bivalirudin versus heparin + GP2b3a inhibitors
ACUITY (Stone) (bivalirudin alone), 2006
NCT00093158
bivalirudin alone
versus
unfractionated heparin or enoxaparin plus a glycoprotein IIb/IIIa inhibitor
patients with acute coronary syndromes open
Follow-up duration: 30 days
HORIZONS-AMI (Stone), 2008
NCT00433966
Bivalirudin
versus
Heparin plus GP IIb/IIIa inhibitor
patients with ST-segment elevation myocardial infarction who presented within 12 hours after the onset of symptoms and who were undergoing primary PCIopen
Follow-up duration: 30 days
11 countries
REPLACE-2, 2003
bivalirudin, with glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibition on a provisional basis for complications during PCI
versus
heparin plus planned Gp IIb/IIIa blockade
patients undergoing urgent or elective PCI double blind
Follow-up duration: 30 days
9 countries
bivalirudin versus UFH
ARMYDA BIVALVE,
bivalirudin (0.75 mg/kg bolus followed by 1.75 mg/kg per hour during the procedure)
versus
unfractionated heparin (75 IU/kg)
patients at high bleeding risk (over 75 years of age, diabetes, reduced renal function) scheduled for PCI
BAT (Bittl), 1995
bivalirudin immediately before angioplasty.
versus
heparin immediately before angioplasty
patients undergoing urgent angioplasty for unstable or postinfarction anginadouble blind
Follow-up duration: hospital stay
US
ISAR-REACT 3, 2008
NCT00262054
UFH bolus of 140 U/kg
versus
bivalirudin (bolus of 0.75 mg/kg, followed by infusion of 1.75 mg/kg/hr)
troponin-negative patients undergoing PCIdouble blind
Follow-up duration: 30 days (mean)
REPLACE-1, 2004
bivalirudin (0.75 mg/kg bolus, 1.75 mg/kg/h infusion during the procedure
versus
heparin (70 U/kg initial bolus) adjusted to ACT of 200 to 300s
patients undergoing elective or urgent revascularization
Follow-up duration: hospital stay (48h min)
US
bivalirudin versus UFH plus tirofiban
NAPLES (Tavano), 2009
bivalirudin monotherapy
versus
unfractionated heparin plus tirofiban
patients with diabetes mellitus undergoing elective percutaneous coronary interventionopen
Follow-up duration: 30 days
Italy
bivalirudin + eptifibatide versus heparin + GP2b3a inhibitors
Kleiman, 2002
bivalirudin + eptifibatide
versus
heparin + eptifibatide
patients who underwent elective percutaneous coronary intervention open
cangrelor versus clopidogrel
CHAMPION PHOENIX, 2013
NCT01156571
bolus and infusion of cangrelor followed by 600mg clopidogrel immediately post-infusion
versus
loading dose of 600 mg or 300 mg of clopidogrel
patients undergoing PCI for stable angina or for acute coronary syndromes, including ST-elevation MIdouble-blind
Follow-up duration: 48 hours
cangrelor up front versus clopidogrel up front
CHAMPION-PCI, 2009
NCT00305162
cangrelor up front (cangrelor administered before percutaneous coronary intervention and followed by clopidogrel)
versus
clopidogrel up front (clopidogrel followed by placebo)
high risk patients requiring PCIdouble blind
Follow-up duration: 48 h
14 countries
cangrelor up front versus delayed clopidogrel
CHAMPION-PLATFORM, 2009
NCT00385138
cangrelor up front (cangrelor during PCI followed by 600 mg of clopidogrel)
versus
delayed clopidogrel (placebo during PCI followed by 600 mg of clopidogrel)
patients with acute coronary syndrome undergoing percutaneous coronary intervention double blind
Follow-up duration: 48 h
18 countries
dalteparin versus UFH
Natarajan (without antiGp2b3a), 2003
Dalteparin 100 IU/kg bolus
versus
UFH 100 IU/kg bolus
Elective or urgent PCI
dalteparin versus UFH + anti Gp2b3a
Natarajan (+ antiGp2b3a), 2003
Dalteparin 70 IU/kg bolus + GP IIb/IIIa inhibitorse/p
versus
UFH 70 IU/kg bolus +GPIIb/IIIa inhibitors
elinogrel versus clopidogrel
INNOVATE PCI,
NCT00751231

versus
enoxaparin versus UFH
ATOLL, 2010
IV enoxaparin
versus
UFH
patients undergoing PCI for acute STEMI open
Follow-up duration: 30 days
Austria, France, Germany, and US
Brieger,
enoxaparin
versus
unfractionated heparin
patients undergoing percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI)
CRUISE, 2003
Enoxaparin 0.75 mg/kg bolus
versus
UFH 60 IU/kg bolus, then titrated to ACT > 200
Urgent or elective PCIopen
Follow-up duration: 2,7 +30 days
Drozd, 2001
Enoxaparin 1 mg/kg bolus
versus
UFH 100 IU/kg bolus
PCI for stable angina
Follow-up duration: 24hrs, 30 days
Dudek, 2000
Enoxaparin 1 mg/kg bolus
versus
UFH titrated to ACT > 300
PCI
Follow-up duration: 3à days
Dudek b (enox alone), 2000
Enoxaparin 1 mg/kg bolus
versus
UFH titrated to ACT > 300
PTCA complex lesionsCI
Galeote, 2001
Enoxaparin 0.75 mg/kg bolus
versus
UFH 70 U/kg bolus, then titrated to ACT > 200
PTCA patients with stable/unstable angina or AMI
Rabah, 1999
Enoxaparin 1 mg/kg bolus
versus
UFH 10,000 IU bolus, then titrated to ACT > 300
PCI for stable anginaopen
STEEPLE, 2006
NCT00077844
enoxaparin (0.5 or 0.75 mg per kilogram of body weight)
versus
unfractionated heparin (adjusted for activated clotting time)
elective percutaneous coronary intervention.open
enoxaparin+abciximab versus UFH
Dubek b (+abciximal), 2001
Enoxaparin 0.75 mg/kg bolus + abciximab
versus
UFH titrated to ACT > 300
Eptifibatide versus placebo
ESPRIT, 2000
loading dose 180µg/kg x2 infusion 2µg/min for 18-24h
versus
Nonurgent PCI
IMPACT (4h), 1995
loading dose 90µg/kg infusion 1.0µg/kg/min for 4h
versus
Elective PCI
IMPACT-II (0.5µg), 1997
loading dose 135µg/kg infusion 0.5µg/kg/min for 20-24h
versus
Any PCI
Harrington, 1995
loading dose µg/kg infusion µg/min for h
versus
prasugrel versus clopidogrel
TRITOM TIMI 38 (PCI subgroup), 2009
prasugrel (60 mg loading, 10 mg maintenance)
versus
clopidogrel (300 mg loading, 75 mg maintenance)
subgroup of patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction
JUMBO-TIMI 26, 2005
Prasugrel 3 doses
versus
clopidogrel 300mg loading dose followed by 75 mg daily)
patients undergoing elective or urgent percutaneous coronary interventiondouble blind
Follow-up duration: 30 days
reviparin versus UFH
REDUCE, 1996
Reviparin 7,000 IU anti-Xa
versus
UFH 10,000 IU bolus
PTCA with stable/unstable anginadouble blind
Follow-up duration: 3 days
Europe and Canada
SCH 530348 versus placebo
TRA-PCI, 2009
NCT00132912
SCH 530348 3 doses: 10mg, 20mg and 40mg
versus
placebo
patients aged 45 years or older and undergoing non-urgent PCI or coronary angiography with planned PCIdouble-blind
sulotroban versus placebo
M-HEART II (sulotroban), 1995

versus
placebo
patients undergoing PTCAdouble blind
Follow-up duration: 6 months
ticlopidine versus placebo
TACT, 1990
ticlopidine 500, aspirin 650 + D225
versus

Follow-up duration: 6m
White (ticlopidine), 1991
ticlopidine 500, aspirin 650 + D225
versus
placebo

Follow-up duration: 6m
Tirofiban versus placebo
RESTORE, 1997
loading dose 10µg/kg infusion 0.15µg/kg/min for 36h
versus
PCI <72 h after USA or MI
Kereiakis, 1996
loading dose µg/kg infusion µg/min for h
versus

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