内皮祖细胞(EPCs)在经皮冠状动脉介入治疗(PCI)后动脉粥样硬化进展和新内膜生长中的作用仍存在争议。这项研究的目的是对PCI患者的EPCs研究进行系统评价和荟萃分析。
我们搜索了Pubmed,Embase和Cochrane数据库,并回顾了截至2021年8月31日的引用参考文献。总的来说,我们选择了9项研究,包括4612名患者。
较低的基线EPC计数与支架内再狭窄的发生率显著增加相关(HR1.33;95%CI0.97-1.82,P=0.045)。至于EPC涂层,EPCs捕获药物洗脱支架(DES)和标准DES之间的1年心源性死亡发生率没有显着差异(相对风险[RR]1.146;95%CI0.666-1.974,P=0.98),但靶病变血运重建(RR1.727;95%CI:1.199-2.487,P=0.025),目标血管失效(RR1.591;95%CI1.213-2.088,P=0.04)在捕获EPCs的DES中明显比标准DES更常见。
循环EPC计数可能改善PCI后的风险分层,因为它与支架内再狭窄的发生有关。目前可用的EPCs捕获DES使用与1年不良事件的风险增加有关。主要由靶病变血运重建和靶血管衰竭的增加驱动,不是心脏死亡。
The role of endothelial progenitor cells (EPCs) in atherosclerosis progression and neointimal growth after percutaneous coronary intervention (PCI) remains controversial. The purpose of this study was to perform a systematic
review and meta-analysis of studies on EPCs in patients who had PCI.
We searched Pubmed, Embase and Cochrane databases and reviewed cited references up to August 31, 2021. Overall, we selected 9 studies, including 4612 patients.
Lower baseline EPC count was associated with a significantly greater occurrence of in-stent restenosis (HR 1.33; 95% CI 0.97-1.82, P = 0.045). As for EPC coating, there was no significant difference in the 1-year occurrence of cardiac death between EPCs-capturing drug-eluting stents (DES) and standard DES (Relative Risk [RR] 1.146; 95% CI 0.666-1.974, P = 0.98), but target lesion revascularization (RR 1.727; 95% CI: 1.199-2.487, P = 0.025), and target vessel failure (RR 1.591; 95% CI 1.213-2.088, P = 0.04) were significantly more common with EPCs-capturing DES than with standard DES.
Circulating EPC count might improve risk stratification after PCI, as it is correlated with the occurrence of in-stent restenosis. Currently available EPCs-capturing DES use was associated with an increased risk of 1-year adverse events, mainly driven by an increase in target lesion revascularization and target vessel failure, not cardiac death.