不同血运重建策略对存在多支血管病变的非ST段抬高型心肌梗死患者预后影响的Meta分析

目的 系统评价不同血运重建策略对存在多支血管病变的非ST段抬高型心肌梗死(NSTEMI)患者预后的影响,以便为临床诊疗提供指导.方法 检索Pubmed、Embase、CNKI及万方数据库,收集与NSTEMI并发多支血管病变采用不同血运重建策略治疗的相关临床随机对照研究,评价纳入研究质量,提取有效数据后通过Revman ...

Meta analysis of the influence of different revascularization strategies on the prognosis of patients with non-ST-segment elevation myocardial infarction with multiple vessel lesions

AIM To systematically evaluate the influence of different revascularization strategies on the prognosis of patients with non-ST-segment elevation myocardial infarction with multi-vessel lesions, so as to provide guidance for clinical diagnosis and treatment. METHODS The databases of Pubmed, Embase, CNKI and Wanfang were searched by computer, and randomized controlled clinical studies on the treatment of non-ST-segment elevation myocardial infarction with multiple vessel lesions using different revascuation strategies were collected to evaluate the quality of the included studies. After extracting effective data, Meta analysis was conducted using Revman 5.3 software. RESULTS A total of 32, 671 patients, including 15, 076 patients who underwent PCI only and 17, 595 patients who underwent PCI with multiple vessels, were included in the final 7 articles. Meta analysis results showed that compared with PCI alone, PCI significantly reduced the incidence of major cardiovascular events (OR=0.77, 95%CI0.60, 0.99], P=0.04), cardiogenic mortality (OR=0.74, 95%CI0.61, 0.89], P=0.002), and the rate of revascularization (OR=0.62, 95%CI0.49, 0.79]). P < 0.0001) and the incidence of recurrent mi (OR=0.71, 95%CI0.58, 0.87], P=0.0008), and the difference was statistically significant, while there was no significant difference in the incidence of all-cause death between the two groups (OR=0.80, 95%CI0.52, 1.21], P=0.29). CONCLUSION PCI is safe and effective in patients with non-ST-segment elevation myocardial infarction (NSTEMI) combined with multiple vessel lesions, and significantly reduces the incidence of MACE events, cardiogenic death, revascularization, and recurrent myocardial infarction, and improves prognosis, compared with PCI alone.