Abstract
Objective To assess the prognostic effects of preventive percutaneous coronary intervention(PCI)in ST- segment elevation myocardial infarction(STEMI)patients with multivessel disease systematically. Methods We systematically searched databases such as PubMed,EMbase,Web of Science,NEJM,CNKI,and CBM from January,2OO1 to July,2O15 to collect relevant literatures related with the prognostic effects of PCI in STEMI,and made manual retrieval of references according to the selected references. We made a meta - analysis of the final selected literatures by RevMan 5. 3 and Stata 11. O statistical software so as to compare the incidence rate,mortality rate,recurrent myocardial infarction rate,re - PCI rate,and coronary artery bypass grafting(CABG)rate of major adverse coronary events(MACE)of patients between preventive PCI group and culprit vessel - only PCI group. Results The total sample size was 1 65O cases,of which 9 qualified references were finally selected and all were English literatures. Meta analysis showed that:(1)MACE incidence rate of the preventive PCI group was significantly lower than that of the culprit vessel - only PCI group〔 OR(95% CI) = O. 46(O. 32,O. 67),P < O. O5〕. Analytical results of the subgroups were shown as follows:subgroup of sample size > 2OO〔 OR(95% CI) = O. 47(O. 28, O. 78),P < O. O5〕,subgroup of sample size≤2OO〔OR(95% CI) = O. 46(O. 25,O. 85),P < O. O5〕,subgroup of follow- up time > 1 year〔 OR(95% CI) = O. 45(O. 23,O. 88),P < O. O5〕,subgroup of follow - up time ≤1 year〔 OR (95% CI) = O. 49(O. 3O,O. 78),P < O. O5〕,MACE incidence rate of the preventive PCI patients in the subgroups was significantly lower than that of the culprit vessel - only PCI group. (2) Mortality rate of patients in preventive PCI group was significantly lower than that of the culprit vessel - only PCI group〔OR(95% CI) = O. 52(O. 35,O. 77),P < O. O5〕. (3) There was no significant difference in the recurrent myocardial infarction rate between patients of the two groups〔OR(95% CI)= O. 67(O. 3O,1. 51),P > O. O5〕. Analytical results of the subgroups were presented as follows:subgroup of sample size≥149〔OR(95% CI) = O. 54(O. 25,1. 15),P > O. O5〕,subgroup of sample size < 149〔OR(95% CI) = 1. 14(O. 18, 7. 11),P > O. O5〕,subgroup of follow - up time > 1 year〔OR(95% CI) = O. 85(O. 12,6. OO),P > O. O5〕,subgroup of follow - up time≤1 year〔 OR(95% CI) = O. 69( O. 27,1. 72),P > O. O5〕,there was no significant difference in the recurrent myocardial infarction rate of patients in the subgroups between the two groups. (4) Re - PCI rate of patients in the preventive PCI group was significantly lower than that of the culprit vessel - only PCI group〔 OR(95% CI) = O. 37(O. 28, O. 5O),P < O. O5〕. (5) There was no significant difference in the undergoing CABG rate between the two groups〔 OR (95% CI) = 1. 31(O. 64,2. 67),P > O. O5〕. Conclusion Compared with the culprit vessel - only PCI,preventive PCI can lower the MACE incidence rate,mortality rate,and the re - PCI rate of STEMI patients with multivessel disease,and further improve the clinical prognosis of patients of such kind to a certain degree.关键词
心肌梗死/血管成形术,气囊,冠状动脉/预后/Meta 分析Key words
Myocardial infarction/Angioplasty,balloon,coronary/Prognosis/Meta - analysis分类
医药卫生
