The effect of nicorandil in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a systematic review and meta-analysis
| Autor: | Rui Zhang, Yangyang Qu, Genshan Ma, Zhenjun Ji, Wenbin Lu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Vasodilator Agents medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Cochrane Library law.invention 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Nicorandil Randomized Controlled Trials as Topic Ejection fraction business.industry Percutaneous coronary intervention General Medicine Prognosis medicine.disease Acute Disease Conventional PCI cardiovascular system Cardiology Female business TIMI medicine.drug |
| Zdroj: | Irish Journal of Medical Science (1971 -). 189:119-131 |
| ISSN: | 1863-4362 0021-1265 |
| Popis: | To study the effect of nicorandil on prognosis of patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).We retrieved literatures from Web of Science, Pubmed, Embase, and Cochrane Library. The retrieval time was limited from inception to December 2018.Nineteen randomized controlled trials involving 2176 patients were finally selected for this study. Meta-analysis showed that nicorandil can significantly reduce corrected TIMI frame count (cTFC) (WMD = - 5.27; 95% CI (- 6.61, - 3.93); P 0.00001) and improve the no-reflow or slow-reflow phenomenon of coronary arteries (thrombolysis in myocardial infarction (TIMI) ≤ 2) (RR = 0.52; 95% CI (0.40, 0.68); P 0.001). Compared with control group, nicorandil group has higher left ventricular ejection fraction (LVEF) (WMD = 3.42; 95% CI (1.32, 5.51); P = 0.001), and subgroup analysis showed that sex ratio was one source of heterogeneity (male/female ratio 4 for low M/F group, M/F 4 for high M/F group). In the low M/F group, LVEF in nicorandil group was increased significantly (WMD = 4.61; 95% CI (3.03, 6.20); P 0.001), while there was no significant difference in LVEF between two groups in the high M/F group (WMD = 1.00; 95% CI (- 1.09, 3.09); P = 0.350). In addition, the incidence of in-hospital reperfusion arrhythmia (RR = 0.47; 95% CI (0.36, 0.63); P 0.00001) and major adverse cardiovascular events (MACEs) (RR = 0.49; 95% CI (0.35, 0.69); P 0.001) were significantly lower in the nicorandil group than that in control group.Nicorandil can improve coronary microcirculation and left ventricular function of patients with AMI after PCI. Interestingly, female patients may benefit more from nicorandil than male patients in improving heart function. |
| Databáze: | OpenAIRE |
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