Hai-Long Wang, Xiao-Hua Pang, Jian-Jun Yang
Department of Cardiology, Chongqing Three Gorges Central Hospital, Wanzhou, Chongqing, China.
Department of Cardiology, Chongqing Three Gorges Central Hospital, 165# Xincheng road Wanzhou, Chongqing, China.
Open Med (Wars). 2018 Sep 8;13:359-365. doi: 10.1515/med-2018-0054. eCollection 2018.
The efficacy and safety of enoxaparin (ENOX) in percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unaddressed. The primary endpoint evaluated was myocardial infarction (MI) or death. The secondary endpoint was defined as major bleeding complications. Studies comparing the differences in the efficacy and safety of ENOX versus unfractionated heparin (UFH) in PCI for the treatment of STEMI were evaluated. We presented the odds ratios for individual studies and performed heterogeneity, quality assessment, and publication bias analysis. This meta-analysis examined four randomized controlled trials (RCTs), and 5585 patients were included (2334 ENOX patients and 3251 UFH patients). The follow-up period of the endpoints was 30 or 90 days. Compared with UFH, ENOX significantly reduced the incidence of MI (OR, 0.74; P<0.01) and death (OR, 0.74; P<0.03), while there was no significant difference between the two treatments on major bleeding (OR,0.81; P=0.33). The findings from this meta-analysis suggested that the efficacy and safety of ENOX in the treatment of STEMI patients undergoing PCI were significantly better than patients treated with UFH. According to this meta-analysis, ENOX is the preferred anticoagulant for STEMI patients receiving PCI compared to UFH.
依诺肝素（ENOX）在ST段抬高型心肌梗死（STEMI）经皮冠状动脉介入治疗（PCI）中的疗效和安全性尚未得到充分研究。评估的主要终点是心肌梗死（MI）或死亡。次要终点定义为严重出血并发症。对比较ENOX与普通肝素（UFH）在PCI治疗STEMI中疗效和安全性差异的研究进行了评估。我们列出了各个研究的比值比，并进行了异质性、质量评估和发表偏倚分析。这项荟萃分析纳入了四项随机对照试验（RCT），共5585例患者（2334例使用ENOX的患者和3251例使用UFH的患者）。终点的随访期为30天或90天。与UFH相比，ENOX显著降低了MI的发生率（OR，0.74；P<0.01）和死亡率（OR，0.74；P<0.03），而两种治疗在严重出血方面无显著差异（OR，0.81；P=0.33）。这项荟萃分析的结果表明，ENOX在治疗接受PCI的STEMI患者中的疗效和安全性显著优于接受UFH治疗的患者。根据这项荟萃分析，与UFH相比，ENOX是接受PCI的STEMI患者的首选抗凝剂。
