经皮冠状动脉介入治疗在胰岛素治疗的糖尿病患者中的应用：一项荟萃分析。

Percutaneous coronary intervention in insulin-treated diabetic patients: A meta-analysis.

机构信息

Department of General Practice, Jinshan Hospital of Fudan University, Shanghai, China.

Center of Emergency & Intensive Care Unit, Jinshan Hospital of Fudan University, Shanghai, China.

出版信息

Ann Noninvasive Electrocardiol. 2022 Sep;27(5):e12953. doi: 10.1111/anec.12953. Epub 2022 Apr 25.

BACKGROUND

This meta-analysis of randomized controlled trials (RCTs) compared long-term adverse clinical outcomes of percutaneous coronary intervention (PCI) in insulin-treated diabetes mellitus (ITDM) and non-ITDM patients.

METHODS

This is a meta-analysis study. The PubMed and Embase databases were searched for articles on long-term adverse clinical outcomes of PCI in ITDM and non-ITDM patients. The risk ratios (RR) and 95% confidence intervals (CI) were calculated.

RESULTS

A total of 11 related RCTs involving 8853 DM patients were included. Compared with non-ITDM patients, ITDM patients had significantly higher all-cause mortality (ACM) (RR = 1.52, 95% CI: 1.25-1.85, p = .689, I = 0%), major adverse cardiac and cerebrovascular events (MACCE) (RR = 1.35, 95% CI: 1.18-1.55, p = .57, I = 0%), myocardial infarction (MI) (RR = 1.41, 95% CI: 1.16-1.72, p = .962, I = 0%), and stent thrombosis (ST) (RR = 1.75, 95% CI: 1.23-2.48, p = .159, I = 32.4%). No significant difference was found in the target lesion revascularization (TLR) and target vessel revascularization (TVR) between the ITDM and non-ITDM groups.

CONCLUSIONS

The results showed that ITDM patients had significantly higher ACM, MACCE, MI, and ST, compared with non-ITDM patients.

背景

本荟萃分析比较了接受经皮冠状动脉介入治疗（PCI）的胰岛素治疗糖尿病（ITDM）和非 ITDM 患者的长期不良临床结局。

方法

这是一项荟萃分析研究。检索了 PubMed 和 Embase 数据库中关于 ITDM 和非 ITDM 患者 PCI 长期不良临床结局的文章。计算了风险比（RR）和 95%置信区间（CI）。

结果

共纳入 11 项涉及 8853 例 DM 患者的相关 RCT。与非 ITDM 患者相比，ITDM 患者的全因死亡率（ACM）（RR=1.52，95%CI：1.25-1.85，p=0.689，I=0%）、主要不良心脑血管事件（MACCE）（RR=1.35，95%CI：1.18-1.55，p=0.57，I=0%）、心肌梗死（MI）（RR=1.41，95%CI：1.16-1.72，p=0.962，I=0%）和支架血栓形成（ST）（RR=1.75，95%CI：1.23-2.48，p=0.159，I=32.4%）的发生率明显更高。ITDM 和非 ITDM 组之间的靶病变血运重建（TLR）和靶血管血运重建（TVR）无显著差异。