Deng Song-Bai, Wang Jing, Xiao Jun, Wu Ling, Jing Xiao-Dong, Yan Yu-Ling, Du Jian-Lin, Liu Ya-Jie, She Qiang
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Cardiology, The Medical Emergency Center of Chongqing, Chongqing, China.
PLoS One. 2014 Nov 18;9(11):e113481. doi: 10.1371/journal.pone.0113481. eCollection 2014.
The aim of this study was to synthesize evidence by examining the effects of manual thrombus aspiration on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).
A total of 26 randomized controlled trials (RCTs), enrolling 11,780 patients, with 5,869 patients randomized to manual thrombus aspiration and 5,911 patients randomized to conventional percutaneous coronary intervention (PCI), were included in the meta-analysis. Separate clinical outcome analyses were based on different follow-up periods. There were no statistically reductions in the incidences of mortality (risk ratio [RR], 0.86 [95% confidence interval [CI]: 0.73 to 1.02]), reinfarction (RR, 0.62 [CI, 0.31 to 1.32]) or target vessel revascularization (RR, 0.89 [CI, 0.75 to 1.05]) in the manual thrombus aspiration arm at 12 to 24 months of follow-up. The composite major adverse cardiac events (MACEs) outcomes were significantly lower in the manual thrombus aspiration arm over the long-term follow-up (RR, 0.76 [CI, 0.63 to 0.91]). A lower incidence of reinfarction was observed in the hospital to 30 days (RR, 0.59 [CI, 0.37 to 0.92]).
The present meta-analysis suggested that there was no evidence that using manual thrombus aspiration in patients with STEMI could provide distinct benefits in long-term clinical outcomes.
本研究旨在通过考察手动血栓抽吸术对ST段抬高型心肌梗死（STEMI）患者临床结局的影响来综合证据。
共有26项随机对照试验（RCT）纳入荟萃分析，涉及11780例患者，其中5869例患者被随机分配至手动血栓抽吸组，5911例患者被随机分配至传统经皮冠状动脉介入治疗（PCI）组。基于不同随访期进行单独的临床结局分析。在12至24个月的随访中，手动血栓抽吸组在死亡率（风险比[RR]，0.86[95%置信区间[CI]：0.73至1.02]）、再梗死率（RR，0.62[CI，0.31至1.32]）或靶血管血运重建率（RR，0.89[CI，0.75至1.05]）方面无统计学意义上的降低。在长期随访中，手动血栓抽吸组的复合主要不良心脏事件（MACE）结局显著更低（RR，0.76[CI，0.63至0.91]）。在住院至30天期间观察到再梗死发生率更低（RR，0.59[CI，0.37至0.92]）。
本荟萃分析表明，没有证据表明在STEMI患者中使用手动血栓抽吸术能在长期临床结局方面带来明显益处。
