Department of Cardiology, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clin Cardiol. 2013 Sep;36(9):E17-24. doi: 10.1002/clc.22169. Epub 2013 Jul 24.
To achieve sufficient myocardial perfusion in ST-segment elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PPCI), many adjunctive therapies have been proposed. Previous trials have reported variances in myocardial perfusion improvement for statin pretreatment, which made it inconvincible to confirm the beneficial effects of statins. Therefore, we performed a systematic review and meta-analysis to determine whether statin pretreatment was effective in improving myocardial perfusion.
Statin pretreatment could improve myocardial perfusion in STEMI patients undergoing PPCI.
We searched the PubMed, Web of Knowledge, and the Cochrane Library databases for studies evaluating the impact of statin pretreatment on myocardial perfusion in STEMI patients receiving PPCI.
Twelve trials were finally included in our meta-analysis. There were no significant differences in patients' baseline characteristics between the statin pretreatment and control groups. Overall pooled analysis showed that patients in the statin pretreatment groups had significantly better epicardial coronary blood flow (measured by Thrombosis in Myocardial Infarction [TIMI] grade, odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.28 to 0.84; measured by corrected TIMI frame count, mean difference: -5.63; 95% CI: -9.66 to -1.6). A trend toward myocardial tissue level perfusion improvement was seen in the statin pretreatment arm rather than the control arm (measured by myocardial blush grade, OR: 0.74; 95% CI: 0.50 to 1.09).
This present meta-analysis suggests that statin pretreatment might be effective in improving myocardial perfusion in STEMI patients.
为了使接受直接经皮冠状动脉介入治疗（PPCI）的 ST 段抬高型心肌梗死（STEMI）患者获得足够的心肌灌注，提出了许多辅助治疗方法。先前的试验报告了他汀类药物预处理对改善心肌灌注的差异，这使得难以确定他汀类药物的有益效果。因此，我们进行了系统评价和荟萃分析，以确定他汀类药物预处理是否能有效改善 STEMI 患者的心肌灌注。
他汀类药物预处理可改善接受 PPCI 的 STEMI 患者的心肌灌注。
我们在 PubMed、Web of Knowledge 和 Cochrane 图书馆数据库中搜索了评估他汀类药物预处理对接受 PPCI 的 STEMI 患者心肌灌注影响的研究。
最终有 12 项试验纳入了我们的荟萃分析。他汀类药物预处理组和对照组患者的基线特征无显著差异。总体汇总分析显示，他汀类药物预处理组患者的心外膜冠状动脉血流明显更好（通过血栓性心肌梗死 [TIMI] 分级测量，比值比 [OR]：0.49，95%置信区间 [CI]：0.28 至 0.84；通过校正 TIMI 帧数测量，平均差异：-5.63；95%CI：-9.66 至 -1.6）。他汀类药物预处理组在心肌组织水平灌注改善方面有改善趋势，而对照组则没有（通过心肌灌注分级测量，OR：0.74；95%CI：0.50 至 1.09）。
本荟萃分析表明，他汀类药物预处理可能有效改善 STEMI 患者的心肌灌注。
