Meta-analysis of randomized controlled trials on the efficacy and safety of intracoronary administration of tirofiban for no-reflow phenomenon

BACKGROUND: Currently, there is still a lack of an optimal treatment for no-reflow phenomenon (NR). The aim of this simple meta-analysis was to evaluate the efficacy and safety of intracoronary (IC) administration of tirofiban compared with other conventional drugs during percutaneous coronary intervention (PCI) for NR. METHODS: Systematic literature search was done from PubMed, EMBASE, Google Scholar, EBSCO, Springer and CNKI databases without language or time limitation. Randomized controlled trials were enrolled for analyzing if they investigated the treatment of IC administration of tirofiban versus other conventional drugs for NR. RESULTS: Ten studies with 702 patients were included. Significantly, the treatment of tirofiban was more effective in improving the thrombolysis in myocardial infarction (TIMI) flow (OR 0.24, 95% CI 0.15-0.37, P < 0.00001) and reducing major adverse cardiovascular events (MACE) (OR 0.09, 95% CI 0.05-0.18, P < 0.00001). There was a trend to increase the risk of bleeding, but the data of the result did not reach the statistical significance (OR 1.44, 95% CI 0.69-3.00, P = 0.32). CONCLUSIONS: Tirofiban is more effective than conventional drugs for NR during PCI, but the potential risk of bleeding complication induced by tirofiban shouldn’t be ignored during clinical practices.