血管内成像对急性心肌梗死经皮冠状动脉介入治疗结果的影响:一项系统回顾和荟萃分析。

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Akshay Machanahalli Balakrishna, Dua Noor Butt, Alexander G Hall, Danielle B Dilsaver, Elissa S Altin, Srihari S Naidu, Jennifer A Rymer, Andrew M Goldsweig
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引用次数: 0

摘要

背景:血管内成像(IVI)有助于经皮冠状动脉介入治疗(PCI)的最佳结果。特别是关于IVI对急性心肌梗死(AMI) PCI治疗结果影响的集中数据很少。方法:系统检索PubMed, EMBASE, Medline和Cochrane数据库,从其建立到2024年12月1日,比较IVI与单独冠状动脉造影指导AMI PCI的研究。研究结果包括全因死亡率(原发性)、心脏死亡率、主要不良心血管事件(MACE)、复发性心肌梗死、靶血管重建术(TVR)、支架血栓形成和靶病变血管重建术(TLR)。采用随机效应模型计算相对危险度(rr),置信区间为95%。结果:14项研究(43 547例)符合纳入标准;9项研究报告了全因死亡率。在AMI患者中,与单独冠脉造影相比,ivi引导下PCI患者的全因死亡率较低(RR: 0.76, 95% CI: 0.64-0.89; P结论:在AMI患者中,与单独冠脉造影相比,ivi引导下PCI与改善临床预后相关。需要进一步的高质量随机试验来阐明获益的程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of intravascular imaging on percutaneous coronary intervention outcomes in acute myocardial infarction: a systematic review and meta-analysis.

Background: Intravascular imaging (IVI) facilitates optimal outcomes in percutaneous coronary intervention (PCI). Focused data on the impact of IVI on outcomes of PCI in acute myocardial infarction (AMI), in particular, are scarce.

Methods: A systematic search of the PubMed, EMBASE, Medline, and Cochrane databases was conducted from their inception to 1 December 2024 for studies comparing IVI to coronary angiography alone to guide PCI in AMI. Outcomes of interest included all-cause mortality (primary), cardiac mortality, major adverse cardiovascular events (MACE), recurrent myocardial infarction, target vessel revascularization (TVR), stent thrombosis, and target lesion revascularization (TLR). Random effects models were used to calculate relative risks (RRs) with 95% confidence intervals (CIs).

Results: Fourteen studies (43 547 patients) met inclusion criteria; nine studies reported all-cause mortality. Among patients with AMI, compared with coronary angiography alone, patients with IVI-guided PCI had lower all-cause mortality (RR: 0.76, 95% CI: 0.64-0.89; P < 0.01). IVI had less cardiac death (RR: 0.71, 95% CI: 0.59-0.86; P < 0.01), MACE (RR: 0.85, 95% CI: 0.77-0.94; P < 0.01), recurrent MI (RR: 0.84, 95% CI: 0.71-99; P = 0.04), TVR (RR: 0.79, 95% CI: 0.70-0.89; P < 0.01), and stent thrombosis (RR: 0.69, 95% CI: 0.53-0.90; P = 0.01). TLR was not significantly different between IVI and coronary angiography alone.

Conclusion: Among patients with AMI, IVI-guided PCI is associated with improved clinical outcomes compared with coronary angiography alone. Further high-quality randomized trials are needed to clarify the magnitude of benefit.

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来源期刊
Coronary artery disease
Coronary artery disease 医学-外周血管病
CiteScore
2.50
自引率
0.00%
发文量
190
审稿时长
6-12 weeks
期刊介绍: Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and​ peer-review by the editors and those invited to do so from a reviewer pool.
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