评估阿昔单抗治疗ST段抬高型心肌梗死患者经皮冠状动脉介入治疗的短期疗效:随机临床试验的荟萃分析

IF 1.6 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of interventional cardiology Pub Date : 2022-05-29 DOI:10.1155/2022/3911414
Nan Bai, Ying Niu, Ying Ma, Yao Shang, Peng-Yu Zhong, Zhilu Wang
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Results Ten randomized controlled trials with 5008 patients met inclusion criteria. There were no significant differences in risk of all-cause death at 30-day (RR 0.79, CI 0.55–1.12, P=0.18), major bleeding (1.37, 0.93–2.03, P=0.11), and transfusion (1.23, 0.94–1.61, P=0.13) between the two groups. However, there were significant differences in risk of all-cause death at 6 months (0.57, 0.36–0.90, P=0.02), recurrent myocardial infarction (0.55, 0.33–0.92, P=0.02), repeat revascularization (0.58, 0.43–0.78, P=0.0004), final TIMI flow <3 (0.77, 0.62–0.96, P=0.02), minor bleeding (1.29, 1.02–1.63, P=0.04), and thrombocytopenia (2.04, 1.40–2.97, P=0.0002). 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引用次数: 0

摘要

目的本荟萃分析旨在验证阿昔单抗在st段抬高型心肌梗死(STEMI)患者行经皮冠状动脉介入治疗(PCI)的短期疗效和安全性。背景阿昔单抗对行PCI的STEMI患者有长期疗效,但近期疗效仍有争议。方法:我们对接受PCI的STEMI患者进行了系统回顾和meta分析,比较了使用或不使用阿昔单抗的情况。通过检索PubMed、EMBASE、Cochrane Library和Web of Science数据库等来源纳入相关随机对照试验。采用固定效应模型计算结果的相对危险度(RR)和95%置信区间(CI)。结果10项随机对照试验5008例患者符合纳入标准。两组患者30天全因死亡风险(RR 0.79, CI 0.55-1.12, P=0.18)、大出血风险(1.37,0.93-2.03,P=0.11)、输血风险(1.23,0.94-1.61,P=0.13)均无显著差异。然而,6个月全因死亡(0.57,0.36-0.90,P=0.02)、复发性心肌梗死(0.55,0.33-0.92,P=0.02)、重复血流量重建(0.58,0.43-0.78,P=0.0004)、最终TIMI流量<3 (0.77,0.62-0.96,P=0.02)、轻度出血(1.29,1.02-1.63,P=0.04)、血小板减少(2.04,1.40-2.97,P=0.0002)的风险差异均有统计学意义。结论应用阿昔单抗可导致6个月后再梗死、血运重建和全因死亡的风险较低,但轻度出血和血小板减少的风险较高。
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Evaluate Short-Term Outcomes of abciximab in ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Clinical Trials
Objectives This meta-analysis was to verify the short-time efficacy and safety of abciximab in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Background Abciximab has long-term efficacy in patients with STEMI undergoing PCI, but the short-term efficacy is still controversial. Methods We conducted a systematic review and meta-analysis compared with or without abciximab in patients with STEMI undergoing PCI. The relevant randomized controlled trials were included by searching PubMed, EMBASE, Cochrane Library, and Web of Science databases and other sources. The relative risk (RR) and 95% confidence intervals (CI) of outcomes were calculated by the fixed-effects model. Results Ten randomized controlled trials with 5008 patients met inclusion criteria. There were no significant differences in risk of all-cause death at 30-day (RR 0.79, CI 0.55–1.12, P=0.18), major bleeding (1.37, 0.93–2.03, P=0.11), and transfusion (1.23, 0.94–1.61, P=0.13) between the two groups. However, there were significant differences in risk of all-cause death at 6 months (0.57, 0.36–0.90, P=0.02), recurrent myocardial infarction (0.55, 0.33–0.92, P=0.02), repeat revascularization (0.58, 0.43–0.78, P=0.0004), final TIMI flow <3 (0.77, 0.62–0.96, P=0.02), minor bleeding (1.29, 1.02–1.63, P=0.04), and thrombocytopenia (2.04, 1.40–2.97, P=0.0002). Conclusions The application of abciximab can lead to a lower risk of reinfarction, revascularization, and all-cause death at 6 months, but a higher risk of minor bleeding, and thrombocytopenia.
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来源期刊
Journal of interventional cardiology
Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.80
自引率
0.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis
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