Meta-analysis of revascularization strategies for STEMI patients during primary PCI
LI Chuang1, CHU Yushun2, WU Guodong1, ZHANG Mei2
1. Graduate Team of Logistics University of PAP, Tianjin 300309, China; 2. Department of Cardiothoracic Surgery,Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin 300162, China
Abstract：Objective To provide evidence-based medical evidence for primary PCI in STEMI patients. Methods Papers published in the Medline, Pubmed, Web of Science, Clinicaltrials.gov, CNKI, Wanfang, and SinoMed before June 2019 were retrieved and screened out via computers while the Jadad score was used to assess the quality of the papers. Meta-analysis was performed with the random effects model, and publication bias was assessed with Egger regression analysis. Results A total of 3,617 patients from 13 studies were enrolled, 1,817 of whom underwent complete revascularization. For STEMI patients, the incidence of MACE (RR=0.562, 95% CI:0.47-0.68, P<0.001), all-cause death (RR=0.654, 95% CI:0.53-0.82, P<0.001) and revascularization rate (RR=0.495, 95% CI: 0.36-0.68, P<0.001) in the complete revascularization group were significantly reduced, but there was no significant difference in the incidence of recurrent myocardial infarction. For AMI patients with cardiogenic shock, complete revascularization reduced the incidence of MACE (RR=0.764, 95% CI: 0.60-0.98, P=0.034). The publication bias was not significant. Conclusions Complete revascularization can reduce the incidence of major cardiovascular adverse events, all-cause death and revascularization in patients with S-T segment elevation myocardial infarction. For acute myocardial infarction patients with cardiogenic shock, complete revascularization can reduce the incidence of major cardiovascular adverse events.
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2020, Vol. 31 
