|
|
|
|
|
Meta-analysis about the efficacy and safety of early administration of tirofiban in Chinese STEMI patients |
Yi Tie-Ci, Weng Hao-Yu, Li Jian-ping, Huo Yong |
Department of Cardiology, Peking University First Hospital, Beijing 100034, China |
|
|
Abstract Objective To assess the efficacy and safety of early use of tirofiban in Chinese population of ST segment elevated myocardial infraction (STEMI) patients receiving primary percutaneous intervention (PCI). Methods We searched English and Chinese databases for articles published before September 30, 2016. The Primary endpoints were the rate of TIMI blood flow grade Ⅲ before and after intervention. The secondary end point was death and major adverse cardiovascular events (MACE) during hospitalization and in 30 days. The safety end point was bleeding and severe bleeding events during hospitalization. Results 29 studies were included in this study. 3248 subjects were involved. The two groups were similar in baseline characterize. Early use of tirofiban significantly increased the rate of TIMI blood flow grade Ⅲ both before and after operation (before operation: RR2.36, 95%CI1.96~2.84,P<0.00001; after operation: RR1.07, 95%CI1.04~1.09,P<0.00001). There was no significant difference in the mortality during hospitalization between the two groups. However, early initiation of tirofiban showed a trend of lower MACE during hospitalization and a significant reduction of MACE events within 30 days. There was no significant difference in safety events between the two groups (bleeding: RR1.10, 95%CI 0.90~1.36, P=0.35; major bleeding: RR1.44,95%CI0.67~3.11, P= 0.35). Conclusion Early application of tirofiban can improve preoperative and postoperative blood perfusion in Chinese STEMI patients without increasing the risk of bleeding.
|
|
Corresponding Authors:
Li Jian-ping, E-mail: 13521531013@163.com
|
|
|
|
[1]De Luca G, Suryapranata H, Stone GW, et al. Abciximab as adjunctive therapy to reperfusion in acute ST-segment elevation myocardial infarction: a meta-analysis of randomized trials[J]. JAMA, 2005, 293(14): 1759-1765.
[2]Van′t Hof AW, Ten Berg J, Heestermans T, et al. Prehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME 2): a multicentre, double-blind, randomised controlled trial[J]. Lancet, 2008, 372(9638): 537-546.
[3]Dudek D, Siudak Z, Janzon M, et al. European registry on patients with ST-elevation myocardial infarction transferred for mechanical reperfusion with a special focus on early administration of abciximab-eurotransfer registry[J]. Am Heart J, 2008, 156(6): 1147-1154.
[4]Khoury C, Dubien PY, Mercier C, et al. Prehospital high-dose tirofiban in patients undergoing primary percutaneous intervention. The AGIR-2 study[J]. Arch Cardiovasc Dis, 2010, 103(5): 285-292.
[5]居海宁,徐迎辉,夏静雯,等. 早期大剂量替罗非班对急性 ST 段抬高型心肌梗死急诊患者介入治疗后血小板及内皮功能的影响[J]. 现代中西医结合杂志, 2014, 26: 2881-2883.
[6]陈玉善,刘鹏,张燕,等. 替罗非班对急性心肌梗死患者急诊PCI治疗疗效的影响[J]. 中国心血管杂志, 2008, 13(1): 34-37.
[7]陈剑峰,薛书峰,张守彦,等. 急性心肌梗死直接PCI术前早期应用替罗非班的有效性和安全性研究[J]. 中国心血管病研究, 2011, 9(8): 596-598.
[8]陈立伟,杨明,高亢,等. 急诊经皮冠状动脉介入术前与术中应用盐酸替罗非班对急性ST段抬高性心肌梗死患者有效性和安全性研究[J]. 中国医师进修杂志, 2011, 34(24): 3-6.
[9]代万林. 提前应用替罗非班对ST段抬高心肌梗死患者急诊介入治疗疗效的影响[J]. 中国医刊, 2011, 46(5): 58-59.
[10]高晓丽,王东颖,刘英华,等. 急诊经皮冠状动脉介入治疗患者早期应用替罗非班的疗效及安全性[J]. 中国心血管病研究, 2012, 10(11): 825-828.
[11]靳志涛,刘宏斌,胡莉华,等. 早期应用替罗非班对急性心肌梗死患者急诊冠状动脉介入治疗术后的影响[J]. 心血管康复医学杂志, 2013, 22(2): 153-156.
[12]李国境,才江平,魏宁. 替罗非班应用时机对急性ST段抬高心肌梗死急诊介入治疗的影响[J]. 中华老年心脑血管病杂志, 2010, 12(11): 987-989.
[13]李勇,周长高,周兵,等. 国产替罗非班在急诊经皮冠状动脉介入术前和术后运用的临床疗效研究[J]. 中国现代医生, 2011, 49(1): 159-160.
[14]李付强. 老年急性ST段抬高性心肌梗死患者急诊PCI术前使用替罗非班的安全性和有效性的研究[J]. 大家健康(中旬版), 2013, 7(7): 34-35.
[15]刘积伦,武胜,周晓林,等. 术前应用替罗非班对急性心肌梗死患者急诊经皮冠状动脉介入治疗疗效的分析[J]. 医学研究杂志, 2012, 41(3): 148-150.
[16]蒙绪宁,卢志红,王孟杰,等. 早期应用替罗非班对≤60岁急性ST段抬高心肌梗死急诊介入治疗术后心肌微循环灌注的影响[J]. 广西医科大学学报, 2013, 30(1): 96-98.
[17]Shen J, Zhang Q, Zhang RY, et al. clinical benefits of adjunctive tirofiban therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention[J]. Coron Artery Dis, 2008, 19(4): 271-277.
[18]谭力力,李潞,赵红丽. 急性ST段抬高型心肌梗死患者支架植入术后早期应用替罗非班的效果观察[J]. 中国医药导刊, 2011, 13(3): 444-446.
[19]王雄关,林文华,宋昱. 急性ST段抬高心肌梗死经皮冠状动脉介入治疗前应用替罗非班的效果[J]. 临床误诊误治, 2009, 22(8): 3-5.[20]王涛,张文海. 替罗非班应用时间不同对急性心肌梗死患者急诊PCI治疗疗效的影响[J]. 中国社区医师(医学专业), 2010, 12(24): 38-39.
[21]王宇航,杨蕾,董淑娟. 急性ST段抬高型心肌梗死患者行急诊PCI时替罗非班的使用时机及安全性[J]. 山东医药, 2012, 52(9): 75-76.
[22]吴剑弟,梁健球,李琛. 急性前壁心肌梗死急诊PCI早期应用替罗非班的疗效观察[J]. 广州医学院学报, 2013, 6: 51-54.〖JP〗
[23]项金洲,罗松辉,胡良焱,等. 提前使用替罗非班在急性STEMI直接PCI中的疗效及安全性研究[J]. 临床心血管病杂志, 2011, 27(10): 760-763.
[24]肖红兵,顾俊,张大东. 早期应用替罗非班对急性心肌梗死急症PCI术后C反应蛋白水平的影响[J]. 介入放射学杂志, 2010, 19(2): 101-104.
[25]徐立,杨新春,王乐丰,等. 提前应用替罗非班对急性ST段抬高心肌梗死患者急诊介入治疗疗效的影响[J]. 中华心血管病杂志, 2006, 34(11): 983-986.
[26]徐育红,付慎文,郑新玲,等. 替罗非班使用时机对急性ST段抬高性心肌梗死患者急诊介入疗效的影响[J]. 中国新药与临床杂志, 2011, 5: 330-334.
[27]徐云根,何义,徐丹蕾. 急诊室使用替罗非班对IRA再通和TIMI血流的影响[J]. 心脑血管病防治, 2012, 12(5): 368-370.
[28]杨模国,罗建平. 提前应用国产替罗非班对急性ST段抬高型心肌梗死患者急诊介入治疗疗效的影响[J]. 中国急救复苏与灾害医学杂志, 2008, 3(8): 471-473.
[29]周勇,黄松群,徐飞. 术前与术中使用替罗非班对急性ST段抬高心肌梗死急诊介入治疗慢血流的比较及安全性[J]. 中国临床药理学与治疗学, 2014, 19(11): 1268-1271.
[30]郑扣龙,卢辉和,盛臻强,等. 不同时间使用替罗非班对急性ST段抬高型心肌梗死行急诊冠脉介入治疗患者的疗效比较[J]. 南通大学学报(医学版), 2015, 5: 374-376, 377.
[31]赵玉君,王东颖,董秋立,等. 老年急性ST段抬高型心肌梗死患者围术期替罗非班不同给药方法比较[J]. 中国老年学杂志, 2014, 24: 6871-6873.
[32]王林,王崇全. STEMI 介入治疗患者急诊提前应用替罗非班的效果及安全性[J]. 心血管康复医学杂志, 2015, 5: 575-578.
[33]陈晖,余淑华,刘毓. 替罗非班在急性ST段抬高型心肌梗死直接PCI术中的应用[J]. 中国实用医刊, 2015, 42(2): 91-92.
[34]Brener SJ, Barr LA, Burchenal JE, et al. Randomized, Placebo-controlled trial of platelet glycoprotein Ⅱb/Ⅲa blockade with primary angioplasty for acute myocardial infarction. Reopro and primary PTCA organization and randomized trial (RAPPORT) investigators[J]. Circulation, 1998, 98(8): 734-741.
[35]ten Berg JM, van′t Hof AW, Dill T, et al. Effect of early, Pre-hospital initiation of high bolus dose tirofiban in patients with ST-segment elevation myocardial infarction on short- and long-term clinical outcome[J]. J Am Coll Cardiol, 2010, 55(22): 2446-2455.
[36]Valgimigli M, CamPo G, Percoco G, et al. Comparison of angioplasty with infusion of tirofiban or abciximab and with implantation of sirolimus-eluting or uncoated stents for acute myocardial infarction: the multistrategy randomized trial[J]. JAMA, 2008, 299(15): 1788-1799.
[37]Maioli M, Bellandi F, Leoncini M, et al. Randomized early versus late abciximab in acute myocardial infarction treated with primary coronary intervention (RELAx-AMI Trial)[J]. J Am Coll Cardiol, 2007, 49(14): 1517-1524.
[38]Ellis SG, Armstrong P, Betriu A, et al. Facilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the facilitated intervention with enhanced reperfusion speed to stop events (FINESSE) trial[J]. Am Heart J, 2004, 147(4): E16.
[39]Ellis SG, Tendera M, de Belder MA, et al. 1-year survival in a randomized trial of facilitated reperfusion: results from the finesse (facilitated intervention with enhanced reperfusion speed to stop events) trial[J]. JACC Cardiovasc Interv, 2009, 2(10): 909-916.
[40]Xu Q, Yin J, Si LY. Efficacy and safety of early versus late glycoprotein Ⅱb/Ⅲa inhibitors for PCI[J]. Int J Cardiol, 2013, 162(3): 210-219.
[41]Liu Y, Su Q, Li L. Safety and efficacy of early administration of tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a meta-analysis[J]. Chin Med J (Engl), 2014, 127(6): 1126-1132.
[42]童程程,唐海沁. 基层医院老年患者抗血小板药物应用分析[J]. 中国临床保健杂志, 2013, 3: 228-231.
[43]李春林,司全金. 北京市某社区医院内科患者抗血小板治疗分析[J]. 中国临床保健杂志, 2011, 2: 151-153.
[44]张丽华. 抗血小板药物在中国急性心肌梗死患者中的应用变化趋势调查2001-2011[D]. 北京协和医学院, 2014.
[45]高铸烨,徐浩,史大卓,等. 5284例住院冠心病患者指南执行及预后分析[Z]. 中国江西南昌:2010.
[46]余娟,张玉芝,张祖峰,等. 冠心病患者依从指南二级预防现状及影响因素分析[J]. 临床心血管病杂志, 2012, 10: 735-737. |
|
|
|