Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi, Medical University, Nanning, Guangxi, 530027, P, R, China.
BMC Cardiovasc Disord. 2013 Sep 10;13:68. doi: 10.1186/1471-2261-13-68.
Currently, there is still a lack of an optimal treatment for no-reflow phenomenon (NR). The aim of this simple meta-analysis was to evaluate the efficacy and safety of intracoronary (IC) administration of tirofiban compared with other conventional drugs during percutaneous coronary intervention (PCI) for NR.
Systematic literature search was done from PubMed, EMBASE, Google Scholar, EBSCO, Springer and CNKI databases without language or time limitation. Randomized controlled trials were enrolled for analyzing if they investigated the treatment of IC administration of tirofiban versus other conventional drugs for NR.
Ten studies with 702 patients were included. Significantly, the treatment of tirofiban was more effective in improving the thrombolysis in myocardial infarction (TIMI) flow (OR 0.24, 95% CI 0.15-0.37, P < 0.00001) and reducing major adverse cardiovascular events (MACE) (OR 0.09, 95% CI 0.05-0.18, P < 0.00001). There was a trend to increase the risk of bleeding, but the data of the result did not reach the statistical significance (OR 1.44, 95% CI 0.69-3.00, P = 0.32).
Tirofiban is more effective than conventional drugs for NR during PCI, but the potential risk of bleeding complication induced by tirofiban shouldn't be ignored during clinical practices.
目前，无复流现象（NR）仍然缺乏最佳治疗方法。本简单荟萃分析旨在评估经皮冠状动脉介入治疗（PCI）期间冠状动脉内（IC）给予替罗非班与其他常规药物相比治疗 NR 的疗效和安全性。
系统检索 PubMed、EMBASE、Google Scholar、EBSCO、Springer 和中国知网（CNKI）数据库，无语言或时间限制。纳入的随机对照试验分析了 IC 给予替罗非班与其他常规药物治疗 NR 的情况。
纳入了 10 项研究，共 702 例患者。替罗非班治疗在改善心肌梗死溶栓治疗（TIMI）血流（OR 0.24，95%CI 0.15-0.37，P < 0.00001）和降低主要不良心血管事件（MACE）（OR 0.09，95%CI 0.05-0.18，P < 0.00001）方面更有效。出血风险有增加的趋势，但结果数据未达到统计学意义（OR 1.44，95%CI 0.69-3.00，P = 0.32）。
替罗非班在 PCI 治疗 NR 方面比常规药物更有效，但在临床实践中不应忽视替罗非班引起的出血并发症的潜在风险。
