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November 10, 2004

Glycoprotein IIb/IIIa Inhibition

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(18):2211-2212. doi:10.1001/jama.292.18.2211-b

To the Editor: Dr Montalescot and colleagues analyzed 6 trials of early vs late Gp IIb/IIIa inhibitors and concluded that early administration confers significant angiographic and clinical benefit.1 I have concerns about whether this interpretation is warranted.

First, it appears that studies using electrocardiographic (ST segment resolution) end points and angiographic (Thrombolysis in Myocardial Infarction [TIMI] flow) end points were combined. It is possible that if the study by Zorman et al2 (which used electrocardiographic criteria as a primary end point) had been excluded from the analysis, the authors would not have found significant benefit.