-
Tytuł:
-
Comparison of early and delayed invasive strategies in short-medium term among patients with non-ST segment elevation acute coronary syndrome: A systematic review and meta-analysis.
-
Autorzy:
-
Zhang MB; The First Medical Clinical College of Lanzhou University, Lanzhou, China.
Guo C; The First Medical Clinical College of Lanzhou University, Lanzhou, China.
Li M; The First Medical Clinical College of Lanzhou University, Lanzhou, China.
Lv YH; The First Medical Clinical College of Lanzhou University, Lanzhou, China.
Fan YD; Department of Cardiology, Emergency General Hospital, Beijing, China.
Wang ZL; The First Medical Clinical College of Lanzhou University, Lanzhou, China.; Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, China.
-
Źródło:
-
PloS one [PLoS One] 2019 Aug 12; Vol. 14 (8), pp. e0220847. Date of Electronic Publication: 2019 Aug 12 (Print Publication: 2019).
-
Typ publikacji:
-
Comparative Study; Journal Article; Meta-Analysis; Systematic Review
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: San Francisco, CA : Public Library of Science
-
MeSH Terms:
-
Percutaneous Coronary Intervention*/methods
Non-ST Elevated Myocardial Infarction/*surgery
Humans ; Non-ST Elevated Myocardial Infarction/mortality ; Time Factors
-
References:
-
J Am Coll Cardiol. 2002 Jun 19;39(12):1924-9. (PMID: 12084589)
Arch Intern Med. 2003 Oct 27;163(19):2345-53. (PMID: 14581255)
JAMA. 2004 Jun 9;291(22):2727-33. (PMID: 15187054)
Am Heart J. 2004 Nov;148(5):764-75. (PMID: 15523305)
Eur Heart J. 2005 Jan;26(1):18-26. (PMID: 15615795)
N Engl J Med. 1992 Jan 30;326(5):310-8. (PMID: 1728735)
Heart. 2009 May;95(10):807-12. (PMID: 19098058)
N Engl J Med. 2009 May 21;360(21):2165-75. (PMID: 19458363)
Am J Cardiol. 2009 Jun 1;103(11):1622-3. (PMID: 19463526)
J Am Coll Cardiol. 2010 Jun 1;55(22):2435-45. (PMID: 20359842)
Eur Heart J. 2011 Jan;32(1):32-40. (PMID: 20709722)
Clin Cardiol. 2010 Oct;33(10):650-5. (PMID: 20960541)
Am J Med. 2011 Jan;124(1):40-7. (PMID: 21187184)
BMJ. 2011 Oct 18;343:d5928. (PMID: 22008217)
Eur Heart J. 2012 Aug;33(16):2035-43. (PMID: 22108830)
Catheter Cardiovasc Interv. 2013 Feb;81(2):223-31. (PMID: 22488783)
EuroIntervention. 2013 May 20;9(1):54-61. (PMID: 23685295)
Korean Circ J. 2013 Nov;43(11):725-30. (PMID: 24363747)
Int J Cardiol. 2014 Nov 15;177(1):23-4. (PMID: 25499327)
BMJ. 2015 Jan 02;350:g7647. (PMID: 25555855)
Int J Cardiol. 2015 Mar 1;182:414-8. (PMID: 25596468)
Atherosclerosis. 2015 Jul;241(1):48-54. (PMID: 25966439)
Neth Heart J. 2016 Mar;24(3):173-80. (PMID: 26860709)
Dtsch Med Wochenschr. 2016 Jun;141(11):782-5. (PMID: 27254627)
Int J Cardiol. 2016 Nov 1;222:1105-1109. (PMID: 27499220)
JACC Cardiovasc Interv. 2016 Nov 28;9(22):2267-2276. (PMID: 27884352)
Lancet. 2017 Aug 19;390(10096):737-746. (PMID: 28778541)
Lancet. 2017 Aug 19;390(10096):717-718. (PMID: 28778542)
Eur Heart J Qual Care Clin Outcomes. 2017 Jan 1;3(1):53-60. (PMID: 28927193)
Front Physiol. 2017 Nov 27;8:952. (PMID: 29230180)
Am J Cardiol. 2018 Jun 1;121(11):1285-1292. (PMID: 29680172)
-
Entry Date(s):
-
Date Created: 20190813 Date Completed: 20200309 Latest Revision: 20200309
-
Update Code:
-
20240104
-
PubMed Central ID:
-
PMC6690510
-
DOI:
-
10.1371/journal.pone.0220847
-
PMID:
-
31404097
-
Background and Objectives: An invasive approach is recommended as the treatment of patients with non-ST elevated acute coronary syndromes (NSTE-ACS). However, it remains unclear that the optimal time of angiography and intervention for patients with NSTE-ACS at present. This study was designed to compare the effect of early and delayed invasive strategies on short-medium term prognosis in patients with those.
Methods: Pubmed, Cochrane Library and Embase were searched up to Dec-30-2018. Randomized clinical trials comparing an early versus a delayed invasive strategy in patients with NSTE-ACS were included. The primary endpoint (all-cause death and recurrent myocardial infarction) and secondary endpoint (major bleeding and recurrent revascularization), as well as composite endpoint were assessed by random or fixed effected meta-analysis with software RevMan 5.3 version after short-medium term follow up.
Result: A total of six randomized clinical trials involving 4,277 early or delayed invasive strategies patients with NSTE-ACS were included in the meta-analysis. Time to coronary angiography varied from 0.5 to 24 h in the early invasive strategy and from 18.6 to 72 h in the delayed invasive strategy. There was a statistical difference in the primary endpoint of all-cause death among patients with NSTE-ACS between early and delayed invasive strategies (4.6% vs 6%; OR:0.76; 95% CI:0.58 to 1.00; P = 0.05; I2 = 0%), but not for recurrent myocardial infarction (6.0% vs 6.3%; OR: 0.94; 95% CI: 0.55 to 1.61; P = 0.82; I2 = 60%). The major bleeding in patients with NSTE-ACS was similar between both invasive strategies (2.7% vs 3.1%; OR:0.88; 95% CI:0.59 to 1.31; P = 0.54; I2 = 0%). However, the composite endpoint in the early invasive strategy patients with NSTE-ACS was significantly lower than that of the delayed invasive strategy (10.9% vs 13.9%; OR:0.76; 95% CI:0.63 to 0.92; P = 0.006; I2 = 0%), and the recurrent revascularization between both strategies was just the opposite (8.7% vs 5.9%; OR:1.5; 95%CI:1.15 to 1.97; P = 0.003; I2 = 0%).
Conclusion: The systematic review and meta-analysis demonstrated that the early invasive strategy had a beneficial trend on all-cause death and significantly reduced the composite endpoint in patients with NSTE-ACS, but increased the rate of revascularization. These data could provide a solution for patients with those.
Competing Interests: The authors have declared that no competing interests exist.
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.
