Therapy

Give abciximab ^{a b}

Why?

• Abciximab reduces myocardial infarction and the need for urgent revascularisation compared with placebo, but increases the risk of major bleeding. ^b  
• Abciximab reduces death, myocardial infarction and the need for urgent revascularisation compared with tirofiban, but causes more thrombocytopenia. ^a There is no clear difference in major bleeding between the two drugs. ^d  
• Eptifibatide reduces death, myocardial infarction and the need for urgent revascularisation compared with placebo.  ^a The effect on major bleeding is unclear.  ^b  

Abciximab reduces myocardial infarction and urgent revascularisation but increases major bleeding

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
angioplasty  b	abciximab	placebo	myocardial infartion at 30 days	8.5%	0.49 (0.40 to 0.59)	24 (20 to 30)
			urgent revascularisation at 30 days	6.9%	0.42 (0.34 to 0.53)	29 (25 to 36)
			major bleeding at 30 days	3.8%	1.53 (1.24 to 1.90)	-53 (-120 to -31)
	eptifibatide or tirofiban	placebo	urgent revasculariation at 30 days	5.5%	0.76 (0.60 to 0.96)	79 (47 to 480)

Abciximab reduces death, MI and urgent revascularisation but increases thrombocytopenia compared with tirofiban

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
angioplasty  b	tirofiban	abciximab	death, non-fatal MI, urgent revascularisation at 30 days	6.0%	-1.58% (-3.00% to -0.153%)	-63 (-650 to -33)
			thrombocytopenia at 30 days	2.4%	1.91% (1.23% to 2.58%)	52 (39 to 81)

Eptifibatide reduces death, MI and urgent revascularisation 

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
elective angioplasty with stenting a	eptifibatide	placebo	death, non-fatal MI, urgent revascularisation at 30 days	22%	21% (6% to 33%)	22 (12 to 88)