急性心肌梗死再灌注治疗后心脏MR检出晚期微血管阻塞和心肌内出血预测主要不良心血管事件的Meta分析

Cardiac MR detection of late microvascular obstruction and intramyocardial hemorrhage in predicting MACE in AMI after reperfusion therapy: Meta-analysis

目的采用Meta分析评价心脏MR(CMR)检出晚期微血管阻塞(MVO)及心肌内出血(IMH)对预测急性心肌梗死(AMI)再灌注患者主要不良心血管事件(MACE)的价值。方法检索PubMed、Embase、Web of Science、中国知网、维普及万方数据库于2018年10月前发表的符合纳入及排除标准的文献。采用RevMan 5.3和STATA 15.1软件对纳入文献数据进行统计学分析和质量评价。结果最终纳入11篇文献,其中9篇内容涉及晚期MVO(共1 872例患者),4篇内容涉及IMH(共1 017例患者)。CMR检出晚期MVO对预测MACE发生的比值比(OR)为4.0495%CI(2.95,5.55),Z=8.65,P<0.001];CMR检出IMH对预测MACE发生的OR为2.6695%CI(1.78,3.96),Z=4.79,P<0.001]。结论 CMR检出晚期MVO和IMH可用于预测AMI再灌注患者随访期间发生MACE。

Objective To explore the predictive value of late microvascular obstruction(MVO)and intramyocaedial hemorrhage(IMH)detected with cardiac MR(CMR)for the major adverse cardiovascular events(MACE)in patients with myocardial infarction(AMI)after reperfusion therapy with Meta-analysis.Methods A systematic search was conducted in databases of PubMed,Embase,Web of Science,CNKI,VIP and Wanfang.The literature published before October 2018 were screened according to inclusion and exclusion criteria.Statistical analysis and quality evaluation were performed using RevMan 5.3 and STATA 15.1 software.Results A total of 11 articles were enrolled.Among them,9 articles related to late MVO with a total of 1 872 patients,and 4 related to IMH with a total of 1 017 patients.Odd ratio(OR)of late MVO detected with CMR predicting MACE occurrence was 4.04(95%CI[2.95,5.55],Z=8.65,P<0.001),of IMH detected with CMR predicting MACE occurrence was 2.66(95%CI[1.78,3.96],Z=4.79,P<0.001).Conclusion The late MVO and IMH detected with CMR after AMI reperfusion therapy can be used to predict MACE during the follow-up.