Efficacy and safety of a bridging strategy that uses intravenous platelet glycoprotein receptor inhibitors for patients undergoing surgery after coronary stent implantation: a meta-analysis

Abstract

Abstract Background Current guidelines indicate we can consider a bridging strategy that uses intravenous, reversible glycoprotein inhibitors for patients that required surgery following recent stent implantation. However, no strong clinical evidence exists that demonstrates the efficacy and safety of this treatment. Therefore, in this study, the efficacy and safety of a bridging strategy that uses intravenous platelet glycoprotein receptor inhibitors will be evaluated. Methods A meta-analysis was performed on preoperative bridging studies in patients undergoing coronary stent surgery. The primary outcome was the success rate of no major adverse cardiovascular events (MACE). The secondary outcomes were the success rate of no reoperations to stop bleeding. Results A total of 10 studies that included 382 patients were used in this meta-analysis. For the primary endpoint, the success rate was 97.7% (95% CI 94.4–98.0%) for glycoprotein IIb/IIIa inhibitors, 98.8% (95% CI 96.0–100%) for tirofiban (6 studies) and 95.8% (95% CI 90.4–99.4%) for eptifibatide (4 studies). For secondary endpoints, the success rate was 98.0% (95% CI 94.8–99.9%) for glycoprotein IIb/IIIa inhibitors, 99.7% (95% CI 97.1–100%) for tirofiban (5 studies), and 95.3% (95% CI 88.5–99.4%) for eptifibatide (4 studies). Conclusion The results of this study showed that the use of intravenous platelet glycoprotein IIb/IIIa inhibitors as a bridging strategy might be safe and effective for patients undergoing coronary stent implantation that require surgery soon after.

Keywords

• Antiplatelet therapy
• Bridging therapy
• Tirofiban
• Eptifibatide
• Surgery