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经皮冠状动脉介入治疗患者肾小球滤过率的影响:系统评价和荟萃分析。

Effect of glomerular filtration rate in patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis.

机构信息

Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, People's Republic of China.

出版信息

Medicine (Baltimore). 2022 Nov 4;101(44):e31498. doi: 10.1097/MD.0000000000031498.

Abstract

BACKGROUND

Through meta-analysis of the relationship between glomerular filtration rate and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), we studied the impact of glomerular filtration rate on the prognosis of PCI.

METHODS

We collected literature on the incidence of MACE in patients with chronic kidney disease (CKD; estimated glomerular filtration rate < 60 mL/minute/1.73 m2) and patients with nonchronic kidney disease undergoing PCI. The search period was from January 1, 2000, to November 1, 2021. The searched databases included CNKI, Chinese Wanfang Data, China Biology Medicine disc, Web of Science, PubMed, and Cochrane Library. We used subgroup analysis and meta-regression to assess heterogeneity.

RESULTS

Twenty-one eligible studies were included, with 46,255 samples included, 4903 cases of MACE (10.6%), and patients with CKD had a higher risk of MACE after PCI (Risk ratios = 1.67; 95% confidence interval: 1.51-1.85). Multivariate meta regression results show that heterogeneity is related to region. The risk of MACEs in patients with CKD is different in different regions, and North America has the lowest risk, with an risk ratios value of 1.21 (95% confidence interval: 1.08-1.35).

CONCLUSION

Chronic kidney disease will increase the probability of MACE in patients with myocardial infarction after PCI and affect the prognosis of PCI. Therefore, clinical attention should be given to assessing glomerular filtration rate effects while treating patients with myocardial infarction with the PCI procedure.

摘要

背景

通过对经皮冠状动脉介入治疗(PCI)后肾小球滤过率与主要不良心血管事件(MACE)之间关系的荟萃分析,我们研究了肾小球滤过率对 PCI 预后的影响。

方法

我们收集了慢性肾脏病(CKD;估计肾小球滤过率<60mL/min/1.73m2)和非慢性肾脏病患者行 PCI 后 MACE 发生率的文献。检索时间为 2000 年 1 月 1 日至 2021 年 11 月 1 日。检索数据库包括中国知网、万方数据、中国生物医学文献数据库、Web of Science、PubMed 和 Cochrane Library。我们使用亚组分析和 meta 回归来评估异质性。

结果

纳入 21 项符合条件的研究,共 46255 例样本,4903 例 MACE(10.6%),CKD 患者 PCI 后发生 MACE 的风险更高(风险比=1.67;95%置信区间:1.51-1.85)。多变量 meta 回归结果显示,异质性与地域有关。CKD 患者发生 MACE 的风险在不同地区有所不同,北美地区的风险最低,风险比为 1.21(95%置信区间:1.08-1.35)。

结论

慢性肾脏病会增加心肌梗死患者 PCI 后发生 MACE 的概率,影响 PCI 的预后。因此,在对心肌梗死患者进行 PCI 治疗时,临床应注意评估肾小球滤过率的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c3e/9646511/222831f99984/medi-101-e31498-g001.jpg

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