Cargando…
Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis
BACKGROUND: Intracoronary (IC) administration of glycoprotein IIb/IIIa inhibitors (GPIs) has been studied as an adjunctive therapy to improve outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. In this systematic review and meta...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347711/ https://www.ncbi.nlm.nih.gov/pubmed/37452333 http://dx.doi.org/10.1186/s12959-023-00519-x |
_version_ | 1785073581018841088 |
---|---|
author | Hahn, JongSung Jeon, Jinyoung Geum, Min Jung Lee, Hyun Woo Shin, Jaekyu Chung, Woo-Young Yu, Yun Mi Ah, Young-Mi |
author_facet | Hahn, JongSung Jeon, Jinyoung Geum, Min Jung Lee, Hyun Woo Shin, Jaekyu Chung, Woo-Young Yu, Yun Mi Ah, Young-Mi |
author_sort | Hahn, JongSung |
collection | PubMed |
description | BACKGROUND: Intracoronary (IC) administration of glycoprotein IIb/IIIa inhibitors (GPIs) has been studied as an adjunctive therapy to improve outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. In this systematic review and meta-analysis, we aimed to evaluate the efficacy and safety of IC administration of GPIs compared with those of intravenous (IV) administration in patients with STEMI. METHODS: We searched the MEDLINE, Embase, and Cochrane CENTRAL databases for relevant studies published before September 21, 2022. In total, 22 randomized controlled trials involving 7,699 patients were included. RESULTS: The proportions of patients achieving thrombolysis in myocardial infarction grade 3 flow, myocardial blush grade 2/3, and complete ST-segment resolution were significantly higher in the IC group than in the IV group. Major adverse cardiac events (MACE) (RR: 0.54, 95% CI: 0.37–0.80) and heart failure (RR: 0.48, 95% CI: 0.25–0.91) within 1 month were significantly lower in the IC group than in the IV group; however, after 6 months, no difference was observed in MACE risk. Additionally, the risks of death and bleeding did not differ between the two routes of administration. CONCLUSIONS: When considering adjunctive GPI administration for patients with STEMI, the IC route may offer greater benefits than the IV route in terms of myocardial reperfusion and reduced occurrence of MACE and heart failure within 1 month. Nonetheless, when making decisions for IC administration of GPIs, the absence of a benefit for bleeding risk and difficulty accessing the administration route should be considered. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12959-023-00519-x. |
format | Online Article Text |
id | pubmed-10347711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103477112023-07-15 Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis Hahn, JongSung Jeon, Jinyoung Geum, Min Jung Lee, Hyun Woo Shin, Jaekyu Chung, Woo-Young Yu, Yun Mi Ah, Young-Mi Thromb J Research BACKGROUND: Intracoronary (IC) administration of glycoprotein IIb/IIIa inhibitors (GPIs) has been studied as an adjunctive therapy to improve outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. In this systematic review and meta-analysis, we aimed to evaluate the efficacy and safety of IC administration of GPIs compared with those of intravenous (IV) administration in patients with STEMI. METHODS: We searched the MEDLINE, Embase, and Cochrane CENTRAL databases for relevant studies published before September 21, 2022. In total, 22 randomized controlled trials involving 7,699 patients were included. RESULTS: The proportions of patients achieving thrombolysis in myocardial infarction grade 3 flow, myocardial blush grade 2/3, and complete ST-segment resolution were significantly higher in the IC group than in the IV group. Major adverse cardiac events (MACE) (RR: 0.54, 95% CI: 0.37–0.80) and heart failure (RR: 0.48, 95% CI: 0.25–0.91) within 1 month were significantly lower in the IC group than in the IV group; however, after 6 months, no difference was observed in MACE risk. Additionally, the risks of death and bleeding did not differ between the two routes of administration. CONCLUSIONS: When considering adjunctive GPI administration for patients with STEMI, the IC route may offer greater benefits than the IV route in terms of myocardial reperfusion and reduced occurrence of MACE and heart failure within 1 month. Nonetheless, when making decisions for IC administration of GPIs, the absence of a benefit for bleeding risk and difficulty accessing the administration route should be considered. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12959-023-00519-x. BioMed Central 2023-07-14 /pmc/articles/PMC10347711/ /pubmed/37452333 http://dx.doi.org/10.1186/s12959-023-00519-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Hahn, JongSung Jeon, Jinyoung Geum, Min Jung Lee, Hyun Woo Shin, Jaekyu Chung, Woo-Young Yu, Yun Mi Ah, Young-Mi Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title | Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title_full | Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title_fullStr | Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title_full_unstemmed | Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title_short | Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis |
title_sort | intracoronary versus intravenous glycoprotein iib/iiia inhibitors during primary percutaneous coronary intervention in patients with stemi: a systematic review and meta-analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10347711/ https://www.ncbi.nlm.nih.gov/pubmed/37452333 http://dx.doi.org/10.1186/s12959-023-00519-x |
work_keys_str_mv | AT hahnjongsung intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT jeonjinyoung intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT geumminjung intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT leehyunwoo intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT shinjaekyu intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT chungwooyoung intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT yuyunmi intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis AT ahyoungmi intracoronaryversusintravenousglycoproteiniibiiiainhibitorsduringprimarypercutaneouscoronaryinterventioninpatientswithstemiasystematicreviewandmetaanalysis |