Clinical effect of postconditioning in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

后适应在接受直接PCI治疗的急性ST段抬高性心肌梗死患者中的临床疗效:基于随机对照试验的meta分析(英文)

Objective： To evaluate the clinical effect of postconditioning on patients with ST-elevation myocardial infarction （STEMI） treated with primary percutaneous coronary intervention （PCI）. Methods： Randomized controlled trials were identified by searching relevant databases published up to April 2nd, 2014. A meta-analysis of eligible studies was performed by Stata 12.0 and Review Manager 5.2 with a fixed-effect model. Results： Ten studies providing adverse cardiac events in a total of 1346 STEMI patients treated with primary PCI were identified. The occurrence of heart failure was significantly reduced in patients treated with postconditioning compared with usual care （risk ratio （RR） 0.533; 95% confidence intervals （CI） 0.368-0.770）, whereas non-fatal reinfarction slightly increased in the postconditioning group （RR 2.746; 95% CI 1.007-7.488）. No significant difference in total major adverse cardiac events （MACEs） was observed between the two groups （RR 0.876; 95% CI 0.671-1.144）. Conclusions： Postcondi- tioning in STEMI patients undergoing primary PCI significantly reduces the risk of heart failure, but fails to decrease the incidence of total MACEs and the risk of non-fatal reinfarction.

目的:探讨后适应对接受直接经皮冠状动脉介入(PCI)治疗的急性ST段抬高性心肌梗死(STEMI)患者心血管不良事件的影响。创新点:进一步明确后适应处理对STEMI患者临床预后的影响。方法:对符合入选标准的随机对照临床试验进行meta分析。结论:缺血后适应显著降低ST段抬高性心肌梗死患者心衰风险。