Gao Zhi-Wei, Huang Ying-Zi, Zhao Hong-Mei, Sun Qing-Song, Luo Man, Pang Li-Qun, Sun Hong
Department of Emergency, Huai'an First People's Hospital, Nanjing Medical University, Huai'an 223300.
Department of Critical Care and Medicine, Zhongda Hospital, Southeast University, Nanjing 210000.
Acta Cardiol Sin. 2017 Nov;33(6):567-577. doi: 10.6515/ACS20170121A.
This study aimed to evaluate the impact of intra-aortic balloon counterpulsation (IABP) on the prognosis of patients with acute myocardial infarction (AMI).
We identified and included in this study AMI cases treated with IABP from January 1970 to May 2014. For statistical analysis, we utilized RevMan 5.0 software.
Fourteen RCTs with a total population of 2538 were included in this study. The in-hospital and 30-day mortality rate in the IABP group was not significantly lower than those in the non-IABP group. Subgroup analysis according to the type of revascularization, OR values of TT subgroup, PCI subgroup, and CABG subgroup were 0.64 (95% CI 0.25-1.61, p = 0.34), 0.85 (95% CI 0.65-1.11, p = 0.23) and 0.46 (95% CI 0.13-1.63, p = 0.23). And OR values of AMI patients in the before and after PCI subgroup were 0.43 (95% CI 0.21-0.91, p = 0.03) and 1.36 (95% CI 0.76-2.41, p = 0.30). The 6-month mortality in the IABP group was not significantly lower than that in the non-IABP group. And OR values of 6-month mortalities of the before and after PCI subgroup were 0.47 (95% CI 0.26-0.86, p = 0.01) and 1.40 (95% CI 0.57-3.45, p = 0.47).
IABP did not reduce the in-hospital and 30-day mortality of AMI patients, and did not reduce the 6-month mortality. But IABP used in AMI patients before PCI was associated not only with reduced in-hospital and 30-day mortality, but also reduced 6-month mortality.
本研究旨在评估主动脉内球囊反搏(IABP)对急性心肌梗死(AMI)患者预后的影响。
我们确定并纳入了1970年1月至2014年5月期间接受IABP治疗的AMI病例。为进行统计分析,我们使用了RevMan 5.0软件。
本研究纳入了14项随机对照试验,总样本量为2538例。IABP组的院内死亡率和30天死亡率并不显著低于非IABP组。根据血运重建类型进行亚组分析,TT亚组、PCI亚组和CABG亚组的OR值分别为0.64(95%可信区间0.25 - 1.61,p = 0.34)、0.85(95%可信区间0.65 - 1.11,p = 0.23)和0.46(95%可信区间0.13 - 1.63,p = 0.23)。PCI术前和术后AMI患者的OR值分别为0.43(95%可信区间0.21 - 0.91,p = 0.03)和1.36(95%可信区间0.76 - 2.41,p = 0.30)。IABP组的6个月死亡率并不显著低于非IABP组。PCI术前和术后6个月死亡率的OR值分别为0.47(95%可信区间0.26 - 0.86,p = 0.01)和1.40(95%可信区间0.57 - 3.45,p = 0.47)。
IABP并未降低AMI患者的院内死亡率和30天死亡率,也未降低6个月死亡率。但在PCI术前应用于AMI患者的IABP不仅与降低院内死亡率和30天死亡率相关,还与降低6个月死亡率相关。