acute coronary syndrome

     

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Trial Studied trt Control trt patientstagsNCTROB Result

anti-anginal drugs

ranolazine
MERLIN TIMI 36, 2007ranolazine placeboNCT00099788suggesting

anticoagulant

apixaban
APPRAISE-1 (10mg od), 2009apixabanplaceboNCT00313300Exploratory negative
APPRAISE-1 (2.5 mg bid), 2009apixabanplaceboNCT00313300 negative
APPRAISE 2, 2011apixabanplaceboNCT00831441Low risk of bias negative
APPRAISE japan ongoing apixabanplaceboNCT00852397Exploratory ongoing
coumadin
ASPECT-2 (coumadin+asp vs asp), 2002coumadincontrol (on top of aspirin)suggesting
ASPECT-2 (coumadin vs aspirin), 2002coumadinaspirinsuggesting
dabigatran
REDEEM, 2009dabigatranplaceboNCT00621855negative
otamixaban
SEPIA-ACS1 TIMI 42, 2009otamixabanunfractionated heparinNCT00317395Exploratory suggesting
rivaroxaban
ATLAS ACS 2 - TIMI 51 (2.5mg), 2011rivaroxaban 2.5mgplaceboNCT00809965Low risk of bias suggesting
ATLAS ACS-TIMI 46 (2.5mg), 2009rivaroxaban 2.5mgplaceboNCT00402597negative
ATLAS ACS 2 - TIMI 51 (5mg), 2011rivaroxaban 5mgplaceboNCT00809965suggesting
ATLAS ACS-TIMI 46 (5mg), 2009rivaroxaban 5mgplaceboNCT00402597negative
warfarin
ATACS (pilot study) (warfarin vs control), 1990warfarincontrol (on top of aspirin)negative
ATACS, 1994warfarincontrol (on top of aspirin)negative
CARS, 1997warfarincontrol (on top of aspirin)negative
OASIS Pilot (phase 1), 1998warfarincontrol (on top of aspirin)negative
OASIS Pilot (phase 2), 1998warfarincontrol (on top of aspirin)negative
OASIS-2 Warfarin Substudy, 2001warfarincontrol (on top of aspirin)negative
APRICOT-2, 2002warfarincontrol (on top of aspirin)negative
CHAMP, 2002warfarincontrol (on top of aspirin)negative
WARIS, 2002warfarincontrol (on top of aspirin)suggesting
LoWASA, 2004warfarincontrol (on top of aspirin)negative
Zibaeenezhad, 2004warfarincontrol (on top of aspirin)negative
Williams, 1997warfarinplacebo (on top of aspirin)negative
Huyhn, 2001warfarinplacebo (on top of aspirin)negative
ATACS (pilot study) warfarin vs aspirin, 1990warfarinaspirinnegative
ximelagatran
ESTEEM, 2003ximelagatranplaceboExploratory -

antiplatelets drug

not classified
Jones, 1987dazoxibencontrolnegative
GRAND, 1987GR3219Bcontrolnegative
Gent-AMI, 1968misc.controlnegative
Johannessen, 1989misc.controlnegative
French, 1993flurbiprofenplacebosuggesting
CURRENT - OASIS 7 (ASA), 2010ASA high doseASA low doseNCT00335452Risk of bias suggesting
aspirin
ATACS-pilot, 1990aspirincontrolnegative
Huddinge, 1988aspirincontrolnegative
Frankfurt, 1976aspirincontrolnegative
VA-pilotaspirinplacebonegative
VA-main, 1983aspirinplacebosuggesting
RISC, 1990aspirinplacebosuggesting
ALDUSA-pilotaspirinplacebonegative
Théroux, 1988aspirinplacebosuggesting
Canadian (Aspirin vs PBO), 1985aspirinplacebo -
Dutch-aspirin, 1990aspirinplacebonegative
ISIS-pilot, 1987aspirinplacebonegative
ISIS-2, 1988aspirinplacebosuggesting
APRICOT, 1993aspirinplacebosuggesting
Canadian (Aspirin + sulfinpyrazone), 1985aspirin + sulfinpyrazoneplacebonegative
atopaxar
J-LANCELOT, 2010atopaxarplaceboExploratory -
LANCELOT ACSatopaxarplaceboExploratory -
clopidogrel
COMMIT, 2005clopidogrelplaceboNCT00222573suggesting
CLARITY-TIMI 28, 2005clopidogrelplacebo -
CURE, 2001clopidogrel + aspirinaspirinsuggesting
CURRENT OASIS 7 (clopidogrel), 2010clopidogrel high-dose regimenclopidogrel standard-doseNCT00335452Low risk of bias negative
dipyridamol
Prandoni, 1991aspirin + dipyridamolplacebonegative
elinogrel
INNOVATE ongoing elinogrelerrorNCT00751231 ongoing
ERASE-MI, 2009elinogrelplaceboExploratory negative
prasugrel
TRILOGY ACS (overall population), 2012prasugrelclopidogrelNCT00699998Low risk of bias negative
TRITON-TIMI 38, 2007prasugrelclopidogrelNCT00097591Low risk of bias suggesting
ACAPULCO ongoing prasugrelclopidogrel ongoing
sulfinpyrazone
Dutch sulphinpyrazone, 1986sulfinpyrazonecontrolnegative
Canadian (sulfinpyrazone alone), 1985sulfinpyrazoneplacebo -
Wilcox, 1980sulfinpyrazoneplacebonegative
Louvain sulphinpyrazone, 1983sulfinpyrazoneplacebonegative
ticagrelor
PLATO, 2009ticagrelorclopidogrelNCT00391872Low risk of bias suggesting
DISPERSE-2 (90mg), 2007ticagrelorclopidogrelExploratory negative
ticlopidine
STAI, 1990ticlopidinecontrolsuggesting
Knudsen-A, 1985ticlopidinecontrolnegative
Florida UAticlopidineplacebonegative
trapidil
Modenatrapidilplacebosuggesting
triflusal
Plaza, 1993triflusalplacebosuggesting
vorapaxar
TRACER, 2011vorapaxarplacebo (on top standard therapy) NCT00527943Low risk of bias -

antithrombotics

not classified
Gurfinkel (LMWH+asp vs asp), 1995LMWHplacebo (on top of aspirin)suggesting
CURRENT - OASIS 7 (ASA), 2010ASA high doseASA low doseNCT00335452Risk of bias suggesting
Gurfinkel (LMWH+asp vs UFH+asp), 1995LMWHUFH (on top of aspirin)suggesting
apixaban
APPRAISE-1 (10mg od), 2009apixabanplaceboNCT00313300Exploratory negative
APPRAISE-1 (2.5 mg bid), 2009apixabanplaceboNCT00313300 negative
APPRAISE 2, 2011apixabanplaceboNCT00831441Low risk of bias negative
APPRAISE japan ongoing apixabanplaceboNCT00852397Exploratory ongoing
argatroban
ARGAMI-2, 1998Argatrobanheparin -
aspirin
ATACS-pilot, 1990aspirincontrolnegative
VA-pilotaspirinplacebonegative
VA-main, 1983aspirinplacebosuggesting
RISC, 1990aspirinplacebosuggesting
ALDUSA-pilotaspirinplacebonegative
Théroux, 1988aspirinplacebosuggesting
Canadian (Aspirin vs PBO), 1985aspirinplacebo -
Canadian (Aspirin + sulfinpyrazone), 1985aspirin + sulfinpyrazoneplacebonegative
atopaxar
LANCELOT ACSatopaxarplaceboExploratory -
J-LANCELOT, 2010atopaxarplaceboExploratory -
bivalirudin
ACUITY (biva alone vs hep+aGP2b3a), 2006bivalirudinheparin + GP2b3a inhibitorsNCT00093158suggesting
ACUITY (biva+aGP2b3a vs hep+aGP2b3a), 2006bivalirudin + GP2b3a inhibitorsheparin + GP2b3a inhibitorsNCT00093158negative
PROTECT-TIMI 30, 2006bivalirudineptifibatide + heparinNCT00250471Exploratory -
HERO, 1997bivalirudinheparinExploratory suggesting
BAT (Bittl), 1995bivalirudinheparinLow risk of bias suggesting
ACUITY (sub groups PCI, bivalirudin alone) importé, 2007bivalirudinheparin + GP2b3a inhibitorssuggesting
ACUITY (sub groups PCI, bivalirudin +aGP2b3a) importé, 2007bivalirudin + GP2b3a inhibitorsheparin + GP2b3a inhibitorsnegative
clopidogrel
CURE (PCI sub study), 2001clopidogrelplaceboExploratory -
CURE, 2001clopidogrel + aspirinaspirinsuggesting
CURRENT OASIS 7 (clopidogrel), 2010clopidogrel high-dose regimenclopidogrel standard-doseNCT00335452Low risk of bias negative
coumadin
ASPECT-2 (coumadin+asp vs asp), 2002coumadincontrol (on top of aspirin)suggesting
ASPECT-2 (coumadin vs aspirin), 2002coumadinaspirinsuggesting
dalteparin
FRISC (long term), 1996dalteparinplacebo (on top of aspirin)Exploratory suggesting
FRIC prolonged treatment phase (LWMH vs PBO), 1997dalteparinplacebo (on top of aspirin)negative
FRISC (short term), 1996dalteparinplacebo (on top of aspirin)Low risk of bias -
FRIC (acute phase LMWH vs UFH), 1997dalteparinUFH (on top of aspirin)Exploratory negative
dipyridamol
Prandoni, 1991aspirin + dipyridamolplacebonegative
Efegatran
Klootwijk, 1999EfegatranheparinExploratory -
enoxaparin
RESCUEenoxaparinunfractionated heparinNCT00077818 -
EVET, 2005enoxaparintinzaparinsuggesting
ESSENCE, 1997enoxaparinUFH (on top of aspirin)suggesting
TIMI 11 B (short term), 1998enoxaparinUFH (on top of aspirin)suggesting
SYNERGY, 2005enoxaparinUFH (on top of aspirin)NCT00043784negative
INTERACT, 2006enoxaparinUFH (on top of aspirin)suggesting
TIMI 11 B (long term), 1998enoxaparinUFH (on top of aspirin)negative
fondaparinux
PENTUA, 2004fondaparinuxenoxaparin -
OASIS 5, 2006fondaparinuxenoxaparinNCT00139815 -
hirudin
HIT-4, 1999HirudinheparinExploratory -
TIMI 9B, 1996HirudinheparinRisk of bias -
GUSTO IIB, 1996HirudinheparinRisk of bias -
OASIS pilot, 1997HirudinheparinExploratory -
HELVETICA (Serruys), 1995HirudinheparinLow risk of bias -
OASIS 2, 1999HirudinheparinLow risk of bias -
OASIS, 1997HirudinheparinRisk of bias -
inogatran
TRIM, 1997InogatranheparinExploratory -
nadroparin
FRAXIS (6days), 1998nadroparinUFH (on top of aspirin)Low risk of bias negative
FRAXIS (14 days), 1998nadroparinUFH (on top of aspirin)negative
otamixaban
SEPIA-ACS1 TIMI 42, 2009otamixabanunfractionated heparinNCT00317395Exploratory suggesting
prasugrel
TRILOGY ACS (overall population), 2012prasugrelclopidogrelNCT00699998Low risk of bias negative
TRITON-TIMI 38, 2007prasugrelclopidogrelNCT00097591Low risk of bias suggesting
ACAPULCO ongoing prasugrelclopidogrel ongoing
rivaroxaban
ATLAS ACS 2 - TIMI 51 (2.5mg), 2011rivaroxaban 2.5mgplaceboNCT00809965Low risk of bias suggesting
ATLAS ACS 2 - TIMI 51 (5mg), 2011rivaroxaban 5mgplaceboNCT00809965suggesting
sulfinpyrazone
Canadian (sulfinpyrazone alone), 1985sulfinpyrazoneplacebo -
ticagrelor
PLATO, 2009ticagrelorclopidogrelNCT00391872Low risk of bias suggesting
DISPERSE-2 (90mg), 2007ticagrelorclopidogrelExploratory negative
ticlopidine
STAI, 1990ticlopidinecontrolsuggesting
Florida UAticlopidineplacebonegative
trapidil
Modenatrapidilplacebosuggesting
triflusal
TIM, 2000triflusalaspirin -
Plaza, 1993triflusalplacebosuggesting
UFH
Holdright, 1994UFHcontrol (on top of aspirin)negative
RISC (heparin+aspirin vs ASP), 1990UFHcontrol (on top of aspirin)negative
Theroux (heparin+ASP vs ASP), 1988UFHcontrol (on top of aspirin)suggesting
ATACS (Cohen), 1994UFH, warfarincontrol (on top of aspirin)negative
Cohen (ATACS pilot) (heparin+aspirin vs asp), 1990UFH, warfarincontrol (on top of aspirin)negative
Theroux (heparin vs PBO), 1988UFHplacebosuggesting
RISC (heparin vs PBO), 1990UFHplacebonegative
Theroux (heparin+aspirin vs PBO), 1988UFH + aspirinplacebosuggesting
RISC (ASP+ heparin vs PBO), 1990UFH + aspirinplacebosuggesting
Gurfinkel (UFH+aspririn vs aspirin), 1995UFHplacebo (on top of aspirin)negative
Cohen (ATACS pilot) (heparin vs asp), 1990UFH, warfarinaspirinnegative
vorapaxar
TRACER, 2011vorapaxarplacebo (on top standard therapy) NCT00527943Low risk of bias -
warfarin
ATACS (pilot study) (warfarin vs control), 1990warfarincontrol (on top of aspirin)negative
ATACS, 1994warfarincontrol (on top of aspirin)negative
CARS, 1997warfarincontrol (on top of aspirin)negative
OASIS Pilot (phase 1), 1998warfarincontrol (on top of aspirin)negative
OASIS Pilot (phase 2), 1998warfarincontrol (on top of aspirin)negative
OASIS-2 Warfarin Substudy, 2001warfarincontrol (on top of aspirin)negative
APRICOT-2, 2002warfarincontrol (on top of aspirin)negative
CHAMP, 2002warfarincontrol (on top of aspirin)negative
WARIS, 2002warfarincontrol (on top of aspirin)suggesting
LoWASA, 2004warfarincontrol (on top of aspirin)negative
Zibaeenezhad, 2004warfarincontrol (on top of aspirin)negative
Williams, 1997warfarinplacebo (on top of aspirin)negative
Huyhn, 2001warfarinplacebo (on top of aspirin)negative
ATACS (pilot study) warfarin vs aspirin, 1990warfarinaspirinnegative
ximelagatran
ESTEEM, 2003ximelagatranplaceboExploratory -

calcium channel blockers

diltiazem
Göbel (Dutch study), 1995diltiazemplacebo -
DRS, 1986diltiazemplacebo -
nifedipine
HINT (nifedipine vs metoprolol), 1988nifedipinemetoprolol -

cholesterol lowering intervention

not classified
JAPAN ACS, 2009pitavastatinatorvastatinacute coronary syndrome early initiation NCT00242944Exploratory -
atorvastatin
MIRACL, 2001atorvastatinplaceboacute coronary syndrome early initiation Low risk of bias suggesting
Colivicchi, 2002atorvastatinusual careacute coronary syndrome early initiation Exploratory negative
ESTABLISH, 2004atorvastatinusual careacute coronary syndrome early initiation Exploratory negative
PROVE IT - TIMI 22, 2004atorvastatinpravastatinacute coronary syndrome early initiation suggesting
ezetimibe
IMPROVE-IT, 2014ezetimibecontrol early initiation NCT00202878suggesting
fluvastatin
LIPS (sub groups), 2002fluvastatinplaceboacute coronary syndrome early initiation Exploratory negative
FLORIDA, 2002fluvastatinplaceboacute coronary syndrome early initiation Low risk of bias negative
Czech trial ongoing fluvastatinplaceboacute coronary syndrome early initiation NCT00171275Exploratory ongoing
pravastatin
LAMIL, 1997pravastatinplaceboacute coronary syndrome early initiation Exploratory negative
RECIFE, 1999pravastatinplaceboacute coronary syndrome early initiation Exploratory negative
PAIS, 2001pravastatinplaceboacute coronary syndrome early initiation Exploratory negative
PACT, 2004pravastatinplaceboacute coronary syndrome early initiation Low risk of bias suggesting
L-CAD, 2000pravastatinusual careacute coronary syndrome early initiation Exploratory suggesting
PTT, 2002pravastatinusual careacute coronary syndrome early initiation Exploratory suggesting
simvastatin
A to Z, 2004simvastatinplaceboacute coronary syndrome early initiation negative

direct factor Xa inhibitors

apixaban
APPRAISE-1 (10mg od), 2009apixabanplaceboNCT00313300Exploratory negative
APPRAISE-1 (2.5 mg bid), 2009apixabanplaceboNCT00313300 negative
APPRAISE 2, 2011apixabanplaceboNCT00831441Low risk of bias negative
APPRAISE japan ongoing apixabanplaceboNCT00852397Exploratory ongoing
dabigatran
REDEEM, 2009dabigatranplaceboNCT00621855negative
otamixaban
SEPIA-ACS1 TIMI 42, 2009otamixabanunfractionated heparinNCT00317395Exploratory suggesting
rivaroxaban
ATLAS ACS 2 - TIMI 51 (2.5mg), 2011rivaroxaban 2.5mgplaceboNCT00809965Low risk of bias suggesting
ATLAS ACS-TIMI 46 (2.5mg), 2009rivaroxaban 2.5mgplaceboNCT00402597negative
ATLAS ACS 2 - TIMI 51 (5mg), 2011rivaroxaban 5mgplaceboNCT00809965suggesting
ATLAS ACS-TIMI 46 (5mg), 2009rivaroxaban 5mgplaceboNCT00402597negative
ximelagatran
ESTEEM, 2003ximelagatranplaceboExploratory -

direct oral anticoagulant (DAO)

apixaban
APPRAISE-1 (10mg od), 2009apixabanplaceboNCT00313300Exploratory negative
APPRAISE-1 (2.5 mg bid), 2009apixabanplaceboNCT00313300 negative
APPRAISE 2, 2011apixabanplaceboNCT00831441Low risk of bias negative
APPRAISE japan ongoing apixabanplaceboNCT00852397Exploratory ongoing
dabigatran
REDEEM, 2009dabigatranplaceboNCT00621855negative
otamixaban
SEPIA-ACS1 TIMI 42, 2009otamixabanunfractionated heparinNCT00317395Exploratory suggesting
rivaroxaban
ATLAS ACS 2 - TIMI 51 (2.5mg), 2011rivaroxaban 2.5mgplaceboNCT00809965Low risk of bias suggesting
ATLAS ACS-TIMI 46 (2.5mg), 2009rivaroxaban 2.5mgplaceboNCT00402597negative
ATLAS ACS 2 - TIMI 51 (5mg), 2011rivaroxaban 5mgplaceboNCT00809965suggesting
ATLAS ACS-TIMI 46 (5mg), 2009rivaroxaban 5mgplaceboNCT00402597negative
ximelagatran
ESTEEM, 2003ximelagatranplaceboExploratory -

fibrinolysis

not classified
TAUSA, 1994intracoronary urokinaseplaceboExploratory negative
anistreplase
UNASEM, 1992anistreplaseplaceboExploratory -
t-pa
Nicklas, 1989t-PAplaceboExploratory negative
Gold, 1987t-PAplaceboExploratory -
Williams, 1990t-PAplaceboExploratory negative
Freeman, 1992t-PAplaceboLow risk of bias negative
van der Brand, 1991t-PAplaceboExploratory negative
charbonnier, 1992t-PAplaceboExploratory -
Ardissino, 1990t-PAplaceboExploratory negative
TIMI 3B, 1995t-PAplaceboLow risk of bias -
Topol, 1988t-PAplaceboExploratory negative
TIMI 3A, 1993t-PAplaceboExploratory -

heparin (UFH or LMWH)

not classified
Gurfinkel (LMWH+asp vs asp), 1995LMWHplacebo (on top of aspirin)suggesting
Gurfinkel (LMWH+asp vs UFH+asp), 1995LMWHUFH (on top of aspirin)suggesting
dalteparin
FRISC (long term), 1996dalteparinplacebo (on top of aspirin)Exploratory suggesting