Abstract：
BACKGROUND: This meta-analysis aimed to evaluate the effects of intracoronary (IC) low-dose tirofiban versus intravenous (IV) administration on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).
METHODS: All published randomised controlled trials (RCTs) comparing the effects of IC low-dose tirofiban (a bolus of ≤10 ug/kg) versus IV administration in patients with STEMI were identified by searching PubMed, EMBASE, Cochrane Library, and ISI Web of Science from inception to June 2023, with no language restriction. The risk ratio (RR) with 95% confidence intervals (CI) and the weighted mean difference (WMD) with 95% CI were calculated.
RESULTS: Eleven RCTs involving 1,802 patients were included. Compared with the IV group, IC low-dose tirofiban was associated with improved major adverse cardiac events rate (RR 0.595, 95% CI 0.442-0.802; p=0.001), left ventricular ejection fraction (WMD 1.982, 95% CI 0.565-3.398; p=0.006), thrombolysis in myocardial infarction (TIMI) flow grade (RR 1.065, 95% CI 1.004-1.131; p=0.037), and TIMI myocardial perfusion grade (RR 1.194, 95% CI 1.001-1.425; p=0.049). The two groups had no significant difference in bleeding events (RR 0.952, 95% CI 0.709-1.279; p=0.745).
CONCLUSIONS: Intracoronary low-dose tirofiban administration may be a safe and effective alternative to IV administration in STEMI patients.
METHODS: All published randomised controlled trials (RCTs) comparing the effects of IC low-dose tirofiban (a bolus of ≤10 ug/kg) versus IV administration in patients with STEMI were identified by searching PubMed, EMBASE, Cochrane Library, and ISI Web of Science from inception to June 2023, with no language restriction. The risk ratio (RR) with 95% confidence intervals (CI) and the weighted mean difference (WMD) with 95% CI were calculated.
RESULTS: Eleven RCTs involving 1,802 patients were included. Compared with the IV group, IC low-dose tirofiban was associated with improved major adverse cardiac events rate (RR 0.595, 95% CI 0.442-0.802; p=0.001), left ventricular ejection fraction (WMD 1.982, 95% CI 0.565-3.398; p=0.006), thrombolysis in myocardial infarction (TIMI) flow grade (RR 1.065, 95% CI 1.004-1.131; p=0.037), and TIMI myocardial perfusion grade (RR 1.194, 95% CI 1.001-1.425; p=0.049). The two groups had no significant difference in bleeding events (RR 0.952, 95% CI 0.709-1.279; p=0.745).
CONCLUSIONS: Intracoronary low-dose tirofiban administration may be a safe and effective alternative to IV administration in STEMI patients.
摘要：
背景：本荟萃分析旨在评估冠状动脉内（IC）低剂量替罗非班与静脉（IV）给药对ST段抬高型心肌梗死（STEMI）患者临床结局的影响。
方法：所有已发表的随机对照试验（RCT）比较了IC低剂量替罗非班（丸剂≤10ug/kg）与IV给药对STEMI患者的影响，EMBASE,科克伦图书馆,和ISIWebofScience从成立到2023年6月，没有语言限制。计算95%置信区间(CI)的风险比(RR)和95%CI的加权平均差(WMD)。
结果：纳入11个RCT，涉及1,802例患者。与IV组相比，IC低剂量替罗非班与改善主要心脏不良事件发生率相关(RR0.595,95%CI0.442-0.802;p=0.001),左心室射血分数(WMD1.982,95%CI0.565-3.398;p=0.006),心肌梗死溶栓(TIMI)血流分级(RR1.065,95%CI1.004-1.131;p=0.037),和TIMI心肌灌注分级（RR1.194，95%CI1.001-1.425；p=0.049）。两组出血事件无显著差异(RR0.952,95%CI0.709-1.279;p=0.745)。
结论：冠状动脉内低剂量替罗非班可能是STEMI患者静脉给药的安全有效替代方案。
方法：所有已发表的随机对照试验（RCT）比较了IC低剂量替罗非班（丸剂≤10ug/kg）与IV给药对STEMI患者的影响，EMBASE,科克伦图书馆,和ISIWebofScience从成立到2023年6月，没有语言限制。计算95%置信区间(CI)的风险比(RR)和95%CI的加权平均差(WMD)。
结果：纳入11个RCT，涉及1,802例患者。与IV组相比，IC低剂量替罗非班与改善主要心脏不良事件发生率相关(RR0.595,95%CI0.442-0.802;p=0.001),左心室射血分数(WMD1.982,95%CI0.565-3.398;p=0.006),心肌梗死溶栓(TIMI)血流分级(RR1.065,95%CI1.004-1.131;p=0.037),和TIMI心肌灌注分级（RR1.194，95%CI1.001-1.425；p=0.049）。两组出血事件无显著差异(RR0.952,95%CI0.709-1.279;p=0.745)。
结论：冠状动脉内低剂量替罗非班可能是STEMI患者静脉给药的安全有效替代方案。
