A systematic review 1 including 17 studies with a total of 4504 subjects was abstracted in DARE. The drugs of interest were high-dose heparin, platelet glycoprotein IIb/IIIa inhibitors, full-dose thrombolytic therapy, reduced-dose thrombolytic therapy, or a combination of both platelet glycoprotein IIb/IIIa inhibitors and reduced-dose thrombolytic therapy. The results are mostly influenced by thrombolytic therapy. The following outcomes were significantly increased as a result of the facilitated intervention compared with the primary PCI: mortality (5% versus 3%) as a (OR 1.38, 95% CI: 1.01 to 1.87, P=0.04); nonfatal reinfarction (3% versus 2%) (OR 1.71, 95% CI: 1.16 to 2.51, P=0.006); urgent target vessel revascularisation (4% versus 1%) (OR 2.39, 95% CI: 1.23 to 4.66, P=0.010); major bleeding (7% versus 5%) (OR 1.51, 95% CI: 1.10 to 2.08, P=0.010). Rates of haemorrhage (0.7% versus 0.1%, P=0.0014) and total stroke (1.1% versus 0.3%, P=0.0008) were higher in those receiving thrombolytic therapy as part of the intervention.
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