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尼可地尔对经皮冠状动脉介入治疗后心肌保护作用的荟萃分析。

Meta-analysis of Nicorandil effectiveness on myocardial protection after percutaneous coronary intervention.

机构信息

Department of Cardiology, Beijing Chao-Yang Hospital, Captial Medical University, 8 Gongti Nanlu Road, Chaoyang District, Beijing, 100020, NO, China.

Department of Internal Medicine, General Political Department Hospital of Chinese PLA, Beijing, China.

出版信息

BMC Cardiovasc Disord. 2019 Jun 14;19(1):144. doi: 10.1186/s12872-019-1071-x.

Abstract

BACKGROUND

Using the current meta-analysis as well as systematic review, to determine the curative effect of Nicorandil in comparison of no Nicorandil after elective percutaneous coronary intervention(PCI) on patients.

METHODS

Published literatures were identified via a computerized literature search of CENTRAL, PubMed, Cochrane, Embase Databases of Systematic Reviews. A set of randomized trials evaluating Nicorandil in comparison of no Nicorandil administered following PCI in patients harboring coronary artery disease were included. Outcomes were revealed based on the following parameters: peak creatine kinase-MB (CK-MB) value, left ventricular ejection fraction (LVEF), peak troponin I (cTnI), and major adverse cardiovascular events (MACEs) per randomized patients.

RESULTS

We included a total of 14 RCTs involving 1864 subjects in the present review. According to this meta-analysis, LVEF was significantly improved in Nicorandil group; the peak CK-MB level and the incidence of adverse cardiovascular events were remarkably lower in Nicorandil group. Nicorandil and no Nicorandil administered group appeared to be equivalent with regards to cTnI.

CONCLUSIONS

Nicorandil is effective for patients undergoing elective PCI with coronary artery disease in terms of reducing the incidence of adverse cardiovascular events as well as improving heart function. Nicorandil may exert potential role as a valid and adjunctive therapy accompanied with PCI.

摘要

背景

本荟萃分析和系统评价旨在评估冠心病患者经皮冠状动脉介入治疗(PCI)后应用尼可地尔与不应用尼可地尔的疗效。

方法

计算机检索CENTRAL、PubMed、Cochrane、Embase 系统评价数据库,收集比较冠心病患者 PCI 术后应用尼可地尔与不应用尼可地尔的随机对照试验。观察指标为:肌酸激酶同工酶峰值(CK-MB)、左心室射血分数(LVEF)、肌钙蛋白 I 峰值(cTnI)、主要不良心血管事件(MACE)。

结果

共纳入 14 项 RCT,合计 1864 例患者。Meta 分析结果显示,尼可地尔组 LVEF 改善更明显,CK-MB 峰值和心血管不良事件发生率更低;两组 cTnI 差异无统计学意义。

结论

尼可地尔可降低冠心病患者 PCI 术后心血管不良事件发生率,改善心功能,可作为 PCI 术后的有效辅助治疗手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/6570907/927be7a4377d/12872_2019_1071_Fig1_HTML.jpg

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