Zheng Chenhong, Liu Shouying, Geng Peiliang, Zhang Huiming, Zhang Hongpeng, Tang Airong, Xie Xiaohua
First Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China ; No. 2 Clinic, Management Support Bureau, Chinese PLA General Logistics Department Beijing 100071, China.
Department of Chinese PLA General Logistics, No. 2 Clinic, Management Support Bureau Beijing 100071, China.
Int J Clin Exp Med. 2015 Feb 15;8(2):2205-11. eCollection 2015.
To assess the efficacy and safety of edaravone for myocardial damage during myocardial ischemia and reperfusion (I/R).
We included randomized controlled trials that compared edaravone with placebo or no intervention in patients with acute myocardial infarction or undergoing coronary artery bypass. Two authors selected eligible trials, assessed trial quality and independently extracted the data.
Seven clinical trials were eventually included and analyzed in this study, involving 148 participants. Four trials were defined as waiting assessment. All of the three remaining trials compared edaravone and another treatment combined with other treatment alone, used the same dose of edaravone injections (60 mg per day) and course of treatment (14 days), evaluated the effect of edaravone at different times, applied different methods, reported adverse events, and showed no differences between the treatment group and the control group. When pooling all of the trials in one dataset, edaravone appeared to decrease the proportion of participant with marked myocardial damage during I/R as compared with the control group. The meta-analysis also revealed decreased CK-MB, cTnI and MDA, and increased content of SOD.
Due to the moderate risk of bias and small sample, our observation of an effective treatment trend of edaravone for I/R requires future larger, high-quality trials to confirm.
评估依达拉奉对心肌缺血再灌注(I/R)期间心肌损伤的疗效和安全性。
我们纳入了比较依达拉奉与安慰剂或对急性心肌梗死患者或接受冠状动脉搭桥手术患者不进行干预的随机对照试验。两位作者选择了符合条件的试验,评估试验质量并独立提取数据。
本研究最终纳入并分析了7项临床试验,涉及148名参与者。4项试验被定义为待评估。其余3项试验均比较了依达拉奉与另一种治疗联合单独使用其他治疗,使用相同剂量的依达拉奉注射液(每日60mg)和疗程(14天),在不同时间评估依达拉奉的效果,应用不同方法,报告不良事件,且治疗组与对照组之间无差异。当将所有试验汇总到一个数据集中时,与对照组相比,依达拉奉似乎降低了I/R期间有明显心肌损伤参与者的比例。荟萃分析还显示CK-MB、cTnI和MDA降低,SOD含量增加。
由于存在中度偏倚风险且样本量小,我们观察到依达拉奉对I/R有有效治疗趋势,这需要未来更大规模、高质量的试验来证实。