Ul Hussain Hassan, Ashok Kumar Kanwal, Zahid Marium, Husban Burney Muhammad, Asif Muqaddus, Tayyaba Rehan Syeda, Abbasher Hussien Mohamed Ahmed Khabab, Ullah Irfan
Dow University of Health Sciences, Karachi, Pakistan.
Karachi Medical and Dental College, Karachi, Pakistan.
Medicine (Baltimore). 2025 Jan 17;104(3):e41132. doi: 10.1097/MD.0000000000041132.
Due to the lack of a prior comprehensive review and meta-analysis, the relationship between monocyte count and thrombus load in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) has not been adequately established.
This was a systematic review and meta-analysis of multiple cohorts (retrospective and prospective) and cross-sectional studies.We queried electronic databases (PubMed, Google Scholar, and Cochrane Central) from their inception to April 2022. The included studies had patients who had undergone PCI treatment and were classified using thrombolysis in myocardial infarction thrombus grading. Dichotomous outcomes from the studies were presented as odds ratios with 95% confidence intervals while means ± standard deviation were presented for continuous outcomes. Means ± standard deviation of monocyte levels and odds ratios were pooled using an inverse variance-weighted random-effects model. I² statistics are used to evaluate heterogeneity across studies and subgrouping was performed to reduce the heterogeneity.
Five eligible studies, consisting of 1426 patients were included, out of which 776 had a high thrombus burden. Pooled results after subgroup analysis showed a significant relationship between raised monocyte count and high thrombus burden (odds ratios = 1.44; 95% confidence interval = 1.06-1.96; P = .02; I2 = 71%). Post-subgroup pooled analysis revealed a statistically significant correlation between high thrombus burden and raised monocyte count.
STEMI patients with a high thrombus burden show an increased monocyte count. A high monocyte count upon admission is a major indication of increased intracoronary thrombus burden in STEMI patients with PCI procedures.
由于此前缺乏全面的综述和荟萃分析，接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者单核细胞计数与血栓负荷之间的关系尚未得到充分确立。
这是一项对多个队列研究（回顾性和前瞻性）及横断面研究的系统综述和荟萃分析。我们检索了从数据库建立至2022年4月的电子数据库（PubMed、谷歌学术和考克兰中心对照试验注册库）。纳入的研究对象为接受PCI治疗的患者，并根据心肌梗死溶栓治疗血栓分级进行分类。研究中的二分结局以比值比及95%置信区间表示，连续结局则以均值±标准差表示。单核细胞水平的均值±标准差及比值比采用逆方差加权随机效应模型进行合并。I²统计量用于评估各研究间的异质性，并进行亚组分析以降低异质性。
纳入了5项符合条件的研究，共1426例患者，其中776例血栓负荷较高。亚组分析后的合并结果显示，单核细胞计数升高与高血栓负荷之间存在显著关联（比值比=1.44；95%置信区间=1.06-1.96；P=0.02；I²=71%）。亚组合并分析显示，高血栓负荷与单核细胞计数升高之间存在统计学显著相关性。
血栓负荷高的STEMI患者单核细胞计数增加。入院时单核细胞计数高是接受PCI手术的STEMI患者冠状动脉内血栓负荷增加的主要指征。
