Immediate vs. delayed stenting in acute myocardial infarction: a systematic review and meta-analysis
| Autor: | Géraud Souteyrand, Jolicœur Em, L Allier Pl, Loic Belle, Lawrence Joseph, Jean-François Tanguay, Xavier Freixa |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Myocardial Infarction Balloon Angioplasty Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary Aged Randomized Controlled Trials as Topic business.industry Percutaneous coronary intervention Middle Aged medicine.disease Confidence interval Surgery Meta-analysis Relative risk Conventional PCI Cardiology Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | EuroIntervention. 8:1207-1216 |
| ISSN: | 1774-024X |
| DOI: | 10.4244/eijv8i10a185 |
| Popis: | Aims To conduct a meta-analysis of studies comparing immediate versus delayed stenting in populations where primary percutaneous coronary intervention (PCI) or early invasive revascularisation was the initial mode of reperfusion. Methods and results We identified five non-randomised studies and one randomised trial for a total of 590 patients in studies comparing immediate to delayed stenting in populations where primary PCI or early invasive revascularisation was the initial mode of reperfusion. In non-randomised studies, delayed stenting was associated with a reduction of procedure-related angiographic events (OR=0.13, 95% credible interval [CrI]: 0.03- 0.36). No differences were observed in the rates of major bleeding (OR=0.81, 95% CrI: 0.01-13.42) and major adverse cardiac events (OR=0.40, 95% CrI: 0.09-1.91), between delayed and immediate stenting. In one randomised trial, delayed stenting was associated with a reduction in myocardial infarction during hospitalisation (39% vs. 60%; relative risk [RR]=0.55, 95% confidence interval [CI]: 0.39-0.80). None of the patients assigned to delayed stenting experienced a major adverse cardiac event in the interval between the initial angiogram and the stenting. Conclusions Delayed stent implantation is associated with better angiographic outcomes. Randomised trials are required to assess whether delayed stenting translates into better long-term cardiac outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|