Prevalence and associated factors of mortality after percutaneous coronary intervention for adult patients with ST elevation myocardial infarction: A systematic review and meta-analysis protocol

BACKGROUND: The percutaneous coronary intervention (PCI) has been one of the fastest growing therapeutic interventions for patients with ST elevation myocardial infarction (STEMI). However, the mortality of patients with STEMI after PCI is uncertain currently. There is a paucity of systematic review on the associated factors of mortality among patients with STEMI after PCI. Therefore, this meta-analysis was designed to synthesize available evidence on the prevalence and associated factors of mortality after PCI for adult patients with STEMI. METHODS: Both case–control and cohort studies reporting on mortality after PCI for patients with STEMI, published in Chinese and English will be eligible for inclusion. Studies from 12 databases covering the period from 2008 to present will be considered for systematic searches. Two reviewers will independently screen and select studies, extract data, and assess methodologic quality. When available, meta-analysis will be performed. Pooled proportions of mortality, and proportions in the exposed and unexposed groups, and population attributable fraction of each factor will be calculated by a suitable transformation of proportions. If necessary, meta-regression models, subgroup analysis, sensitivity analysis, funnel plot, and Egger test will be performed. Narrative synthesis will be done where meta-analysis cannot be performed. Reporting of this protocol will comply with the preferred reporting items for systematic review and meta-analyses (PRISMA-P) guidelines. RESULTS: This systematic review will be developed according to the meta-analysis of observational studies in epidemiology (MOOSE) guidelines. CONCLUSION: This study will provide a comprehensive review on the available evidence regarding the prevalence and associated factors of mortality for patients with STEMI following PCI. This review will be constrained by the divergence of definition and assessment of specific factors between studies. However, the development of a qualitative description of definition and assessment tools will also provide an overview of the current practice. Formal ethical approval is not required since the secondary data will be collected for systematic review. The findings will be disseminated in a relevant peer-reviewed journal and academic presentations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017070969