Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis
Pooled result · MACEResult — go to the resultRelative risk 0.65 95% CI 0.51–0.82Authors' conclusion
Adjunctive IC thrombolysis at the time of primary PCI in patients with STEMI improves clinical and myocardial perfusion parameters without an increased rate of bleeding.
Study context
- Population
- Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI)
- Participants
- 1,915 patients12 studies
- Comparison
- Adjunctive intracoronary thrombolysis vs no intracoronary (IC) thrombolysis at primary PCI
- Outcome
- MACE
Pooled result
As reported in the abstract
Relative risk
0.65
95% CI 0.51–0.82
P < 0.0004
IC thrombolysisvs No IC thrombolysis
RR 0.65 (95% CI 0.51–0.82); P < 0.0004
Further pooled results
| Outcome | WMD (95% CI) | P value | |
|---|---|---|---|
| LVEFI2=25% | 1.87 (1.07–2.67) | P < 0.0001 | |
| −2024Difference (linear scale) |
Major adverse cardiac events (MACE) by thrombolytic agent fibrin specificity (subgroup)
- Non-fibrin agents: RR
- 0.39 (95% CI 0.20 to 0.78, I2=0%, p=0.007)
- Moderately fibrin-specific agents: RR
- 0.62 (95% CI 0.47 to 0.83, I2=0%, p=0.001)
- Highly fibrin-specific agents: no significant reduction, RR
- 1.10 (95% CI 0.62 to 1.96, I2=0%, p=0.75)
Mortality
- No significant difference in mortality, RR
- 0.91 (95% CI 0.48 to 1.71; I2=0%; p=0.77)
Safety
Major bleeding
- No significant difference in major bleeding, RR
- 1.24 (95% CI 0.47 to 3.28; I2=0%; p=0.67)
Minor bleeding
- No significant difference in minor bleeding, RR
- 1.47 (95% CI 0.90 to 2.40; I2=0%; p=0.12)
Original publication
Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis. Heart. Published 26 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →