一项评估经皮冠状动脉介入治疗期间缺血预处理的系统评价和荟萃分析。
A systematic review and meta-analysis evaluating ischemic conditioning during percutaneous coronary intervention.
作者信息
Blusztein David I, Brooks Matthew J, Andrews David T
机构信息
Cardiology Registrar, Department of Cardiology, The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria 3050, Australia.
Cardiologist, Department of Cardiology, The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria 3050, Australia.
出版信息
Future Cardiol. 2017 Nov;13(6):579-592. doi: 10.2217/fca-2017-0042. Epub 2017 Oct 27.
AIM
A systematic review and meta-analysis, evaluating ischemic conditioning during percutaneous coronary intervention (PCI).
METHODS & RESULTS: A database search of randomized trials of ischemic conditioning in PCI created three subgroups for meta-analysis: mortality in elective PCI with remote ischemic preconditioning (RIPreC; subgroup 1a, n = 3) - no outcome difference between RIPreC and control (odds ratio: 0.34; 95% CI: 0.08-1.56), myocardial salvage index in ST-elevation myocardial infarction (STEMI) with RIPreC (subgroup 1b, n = 2) - favored RIPreC (mean difference: 0.13; 95% CI: 0.07-0.19), and infarct size in STEMI with local ischemic postconditioning (LIPostC) (subgroup 4b, n = 12) - favored LIPostC (mean difference: -4.13 g.m; 95% CI: -7.36 to -0.90 g.m).
CONCLUSION
RIPreC and LIPostC improve myocardial salvage index and myocardial infarct size respectively in PCI for STEMI. No mortality benefit detected with RIPreC in elective PCI.
目的
进行一项系统评价和荟萃分析，评估经皮冠状动脉介入治疗（PCI）期间的缺血预处理。
方法与结果
对PCI中缺血预处理的随机试验进行数据库检索，创建了三个亚组进行荟萃分析：择期PCI中远程缺血预处理（RIPreC）的死亡率（亚组1a，n = 3）——RIPreC与对照组之间无结果差异（优势比：0.34；95%置信区间：0.08 - 1.56）；ST段抬高型心肌梗死（STEMI）中RIPreC的心肌挽救指数（亚组1b，n = 2）——支持RIPreC（平均差异：0.13；95%置信区间：0.07 - 0.19）；STEMI中局部缺血后处理（LIPostC）的梗死面积（亚组4b，n = 12）——支持LIPostC（平均差异：-4.13 g.m；95%置信区间：-7.36至-0.90 g.m）。
结论
在STEMI的PCI中，RIPreC和LIPostC分别改善心肌挽救指数和心肌梗死面积。在择期PCI中未检测到RIPreC对死亡率的益处。
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