Objective　　　To systematically evaluate the efficacy and safety of small-molecule glycoprotein Ⅱb/Ⅲa inhibitors (GPI) in percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).　　　 Methods　　　A search was conducted in PubMed

EMBASE

OVID

CBM

CNKI and VIP for the randomized controlled trials (RCTs) of small-molecule GPI versus placebos in PCI for ACS from the date of their establishment to July 31

2012

and the bibliographies of the included studies were also searched. According to the criteria of the Cochrane Handbook

two reviewers evaluated the quality of the included RCTs and extracted data independently

and then the extracted data were analyzed by using RevMan 5.1 software.　　　 Results　　　Ten RCTs involving 9 518 ACS patients treated with PCI were included. The results of Meta-analysis showed that: (1) Compared with placebos

small-molecule GPI decreased major adverse cardiovascular events (MACE) in 7 and 30 d

and 6 months [RR=0.71

95％CI (0.55

0.94)

P0.05; RR=0.85

95%CI (0.73

0.98)

P0.05; RR=0.73

95%CI (0.55

0.99)

P0.05]. The incidences of target vessel revascularization  (TVR)  in 30 d and re-myocardial infarction (MI) in 6 months also decreased [RR=0.75

95%CI (0.58

0.96)

P0.05; RR=0.67

95%CI(0.53

0.83)

P0.01]. But for the mortality in 30 d and 6 months

the re-MI in 30 d and the TVR in 6 months showed no significant differences between the 2 groups [RR=0.65

95%CI (0.41

1.04)

P0.05; RR=0.87

95%CI (0.58

1.32)

P0.05; RR=0.80

95%CI (0.65

1.00)

P=0.05; RR=0.90

95%CI (0.79

1.02)

P0.05]. (2) Compared with placebos

small-molecule GPI were associated with high risk of minor and major bleeding complications [RR=1.60

95%CI (1.24

2.07)

P0.01; RR=1.44

95%CI (1.09

1.89)

P0.05]. However

the incidence of thrombocytopenia was not significantly different between the 2 groups [RR=1.16

95%CI (0.63

2.14)

P0.05].　　　 Conclusion　　　Small-molecule GPI have positive effect in PCI for ACS

but they are associated with high risk of bleeding complications.