综合分析

Quan-Li Zhu, Wei Wu
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摘要

背景:对于有症状的二尖瓣返流的高危手术患者,经导管二尖瓣修复已被证明是安全的,并能改善临床结果。然而,在最近的试验中,它对生存的影响显示出相互矛盾的结果。方法查询PubMed、EMBASE和谷歌Scholar数据库,查询有关MitraClip与最佳药物治疗的所有试验。结果对9项试验,包括3099例患者进行的荟萃分析发现,与最佳药物治疗相比,接受MitraClip治疗的患者30天死亡率相似(OR 0.64, 95% CI 0.32- 1.28),而在12个月时,MitraClip与显著降低的全因死亡率相关(OR 0.50, 95% CI 0.38- 0.66)。绝对风险降低13.9%,12个月时挽救1条生命所需治疗的人数为7.2人。背景:MitraClip装置经皮二尖瓣(MV)修复对严重二尖瓣返流(MR)患者有效。需要肌力药物或机械循环支持(MCS)的NYHA IV型心力衰竭患者已被排除在先前的MitraClip研究之外。同时存在肾功能衰竭在这类患者中很常见。MitraClip对肾功能的影响尚不清楚。对经皮或严重的肾功能进行了一系列的评估
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META ANALYSIS
BACKGROUND In patients with symptomatic mitral regurgitation who are high-risk for surgery, transcatheter mitral valve repair has been shown to be safe and improve clinical outcomes. However, its impact on survival has shown con fl icting results in recent trials. METHODS PubMed, EMBASE, and Google Scholar databases were queried for all trials about MitraClip compared with optimal medical therapy RESULTS This meta-analysis of 9 trials, including 3099 patients, found that patients treated with MitraClip compared to optimal medical therapy had similar 30-day mortality (OR 0.64, 95% CI 0.32- 1.28) while at 12-months MitraClip was associated with signi fi cantly lower all-cause mortality (OR 0.50, 95% CI 0.38- 0.66). Absolute risk reduction was 13.9%, and number needed to treat to save 1 life at 12 months was 7.2. Percutaneous Mitral Valve BACKGROUND Percutaneous mitral valve (MV) repair with the MitraClip device is effective in patients with severe mitral regurgitation (MR). Patients with NYHA IV heart failure requiring inotropes or mechanical circulatory support (MCS) have been excluded from prior MitraClip studies. Co-existing renal failure is common in such pa- tients. The impact of MitraClip on renal function is not known. underwent percutaneous for or severe Renal function was assessed with serial the
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