西莫羅斯洗脫支架與裸支架治療ST段升高的急性心肌梗死隨機對照試驗的Meta分析_《中國循證醫學雜志》

作者：

唐楊 ,  唐學文

重慶市巴南區人民醫院（重慶 401320）;

關鍵詞：

西羅莫司洗脫支架裸支架 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20120031

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價西莫羅斯洗脫支架（SES）與裸支架（BMS）比較治療ST段升高的急性心肌梗死的有效性和安全性。
方法　計算機檢索PubMed（1960～2011.3）、EMbase（1980～2011.3）、Cochrane圖書館（1989～2011.3）、CBM（1979～2011.3）、VIP（1989～2011.3）和CNKI（1979～2011.3），納入西莫羅斯洗脫支架與裸支架比較治療ST段升高的急性心肌梗死的隨機對照試驗（RCT）。對納入研究進行資料提取和方法學質量評價后，采用RevMan 4.2軟件進行Meta分析。
結果　共納入7個RCT，2 555例患者，其中SES組1 282例，BMS組1 273例，Jadad評分均≥ 3。Meta分析結果顯示，SES組在靶病變血運重建率［OR=0.27，95%CI（0.16，0.45），P lt;0.000 01］及靶血管血運重建率［OR=0.33，95%CI（0.24，0.46），P lt;0.000 01］方面均優于BMS組，但在病死率、支架內血栓形成率以及心肌梗死再發生率方面，兩組差異無統計學意義。
結論　從1年期的臨床結果來看，相比裸支架而言，西羅莫司洗脫支架可以有效降低靶病變血運重建率和靶血管血運重建率。

引用本文： 唐楊,唐學文. 西莫羅斯洗脫支架與裸支架治療ST段升高的急性心肌梗死隨機對照試驗的Meta分析. 中國循證醫學雜志, 2012, 12(2): 188-193. doi: 10.7507/1672-2531.20120031 復制

1.	Fox KA, Steg PG, Eagle KA, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999–2006. JAMA, 2007, 297(17): 1892-1900.
2.	Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics–2007 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2007, 115(5): e69-e171.
3.	Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomised trials. Lancet, 2003, 361(9351): 13-20.
4.	Mehta SR, Cannon CP, Fox KA, et al. Routine vs. selective invasive strategies in patients with acute coronary syndromes: A collaborative meta-analysis of randomized trials. JAMA, 2005, 293(23): 2908-2917.
5.	Boersma E. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital ?brinolysis in acute myocardial infarction patients. Eur Heart J, 2006, 27(7): 779-788.
6.	Zhu MM, Feit A, Chadow H, et al. Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials. Am J Cardiol, 2001, 88(3): 297-301.
7.	De Luca G, Suryapranata H, Stone GW, et al. Coronary stenting versus balloon angioplasty for acute myocardial infarction: A meta-regression analysis of randomized trials. Int J Cardiol, 2008, 126(1): 37-44.
8.	Brophy JM, Belisle P, Joseph L. Evidence for use of coronary stents. A hierarchical Bayesian meta-analysis. Ann Intern Med, 2003, 138(10): 777-786.
9.	Suryapranata H, De Luca G, van‘t Hof AW, et al. Is routine stenting for acute myocardial infarction superior to balloon angioplasty? A randomised comparison in a large cohort of unselected patients. Heart, 2005, 91(5): 641–645.
10.	Stone GW, Grines CL, Cox DA, et al. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. N Engl J Med, 2002, 346(13): 957-966.
11.	Maillard L, Hamon M, Khalife K, et al. A comparison of systematic stenting and conventional balloon angioplasty during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction. STENTIM-2 Investigators. J Am Coll Cardiol, 2000, 35(7): 1729-1736.
12.	Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med, 2003, 349(14): 1315-1323.
13.	Schofer J, Schluter M, Gershlick AH, et al. Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: Double-blind, randomised controlled trial (E-SIR-IUS). Lancet, 2003, 362(9390): 1093-1099.
14.	Dibra A, Kastrati A, Alfonso F, et al. Effectiveness of drug-eluting stents in patients with bare-metal in-stent restenosis: meta-analysis of randomized trials. J Am Coll Cardiol, 2007, 49(5): 616-623.
15.	Kastrati A, Mehilli J, Pache J, et al. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med, 2007, 356(10): 1030-1039.
16.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996, 17(1): 1-12.
17.	Valgimigli M, Percoco G, Malagutti P, et al. Tirofiban and sirolimus-eluting stent vs abciximab and bare-metal stent for acute myocardial infarction: a randomized trial. JAMA, 2005, 293(17): 2109-2117.
18.	Spaulding C, Henry P, Teiger E, et al. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med, 2006, 355(11): 1093-1104.
19.	Menichelli M, Parma A, Pucci E, et al. Randomized trial of sirolimus-eluting stent versus bare-metal stent in acute myocardial infarction (SESAMI). J Am Coll Cardiol, 2007, 49(19): 1924-1930.
20.	Diaz de la Llera LS, Ballesteros S, Nevado J, et al. Sirolimus-eluting stents compared with standard stents in the treatment of patients with primary angioplasty. Am Heart J, 2007, 154(1): 164 e1-164 e6.
21.	van der Hoeven BL, Liem SS, Jukema JW, et al. Sirolimus-eluting stents versus bare-metal stents in patients with ST-segment elevation myocardial infarction: 9-month angiographic and intravascular ultrasound results and 12-month clinical outcome results from the MISSION! Intervention Study. J Am Coll Cardiol, 2008, 51(6): 618-626.
22.	Valgimigli M, Campo G, Percoco G, et al. Comparison of angioplasty with infusion of tiro?ban or abciximab and with implantation of sirolimus-eluting or uncoated stents for acute myocardial infarction: The MULTI-STRATEGY randomized trial. JAMA, 2008, 299(15): 1788-1799.
23.	Di Lorenzo E, De Luca G, Sauro R, et al. The PASEO (PaclitAxel or Sirolimus-Eluting Stent Versus Bare Metal Stent in Primary Angioplasty) Randomized Trial. JACC Cardiovasc Interv, 2009, 2(6): 515-523.

1. Fox KA, Steg PG, Eagle KA, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999–2006. JAMA, 2007, 297(17): 1892-1900.
2. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics–2007 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2007, 115(5): e69-e171.
3. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: A quantitative review of 23 randomised trials. Lancet, 2003, 361(9351): 13-20.
4. Mehta SR, Cannon CP, Fox KA, et al. Routine vs. selective invasive strategies in patients with acute coronary syndromes: A collaborative meta-analysis of randomized trials. JAMA, 2005, 293(23): 2908-2917.
5. Boersma E. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital ?brinolysis in acute myocardial infarction patients. Eur Heart J, 2006, 27(7): 779-788.
6. Zhu MM, Feit A, Chadow H, et al. Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials. Am J Cardiol, 2001, 88(3): 297-301.
7. De Luca G, Suryapranata H, Stone GW, et al. Coronary stenting versus balloon angioplasty for acute myocardial infarction: A meta-regression analysis of randomized trials. Int J Cardiol, 2008, 126(1): 37-44.
8. Brophy JM, Belisle P, Joseph L. Evidence for use of coronary stents. A hierarchical Bayesian meta-analysis. Ann Intern Med, 2003, 138(10): 777-786.
9. Suryapranata H, De Luca G, van‘t Hof AW, et al. Is routine stenting for acute myocardial infarction superior to balloon angioplasty? A randomised comparison in a large cohort of unselected patients. Heart, 2005, 91(5): 641–645.
10. Stone GW, Grines CL, Cox DA, et al. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. N Engl J Med, 2002, 346(13): 957-966.
11. Maillard L, Hamon M, Khalife K, et al. A comparison of systematic stenting and conventional balloon angioplasty during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction. STENTIM-2 Investigators. J Am Coll Cardiol, 2000, 35(7): 1729-1736.
12. Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med, 2003, 349(14): 1315-1323.
13. Schofer J, Schluter M, Gershlick AH, et al. Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: Double-blind, randomised controlled trial (E-SIR-IUS). Lancet, 2003, 362(9390): 1093-1099.
14. Dibra A, Kastrati A, Alfonso F, et al. Effectiveness of drug-eluting stents in patients with bare-metal in-stent restenosis: meta-analysis of randomized trials. J Am Coll Cardiol, 2007, 49(5): 616-623.
15. Kastrati A, Mehilli J, Pache J, et al. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med, 2007, 356(10): 1030-1039.
16. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996, 17(1): 1-12.
17. Valgimigli M, Percoco G, Malagutti P, et al. Tirofiban and sirolimus-eluting stent vs abciximab and bare-metal stent for acute myocardial infarction: a randomized trial. JAMA, 2005, 293(17): 2109-2117.
18. Spaulding C, Henry P, Teiger E, et al. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med, 2006, 355(11): 1093-1104.
19. Menichelli M, Parma A, Pucci E, et al. Randomized trial of sirolimus-eluting stent versus bare-metal stent in acute myocardial infarction (SESAMI). J Am Coll Cardiol, 2007, 49(19): 1924-1930.
20. Diaz de la Llera LS, Ballesteros S, Nevado J, et al. Sirolimus-eluting stents compared with standard stents in the treatment of patients with primary angioplasty. Am Heart J, 2007, 154(1): 164 e1-164 e6.
21. van der Hoeven BL, Liem SS, Jukema JW, et al. Sirolimus-eluting stents versus bare-metal stents in patients with ST-segment elevation myocardial infarction: 9-month angiographic and intravascular ultrasound results and 12-month clinical outcome results from the MISSION! Intervention Study. J Am Coll Cardiol, 2008, 51(6): 618-626.
22. Valgimigli M, Campo G, Percoco G, et al. Comparison of angioplasty with infusion of tiro?ban or abciximab and with implantation of sirolimus-eluting or uncoated stents for acute myocardial infarction: The MULTI-STRATEGY randomized trial. JAMA, 2008, 299(15): 1788-1799.
23. Di Lorenzo E, De Luca G, Sauro R, et al. The PASEO (PaclitAxel or Sirolimus-Eluting Stent Versus Bare Metal Stent in Primary Angioplasty) Randomized Trial. JACC Cardiovasc Interv, 2009, 2(6): 515-523.

上一篇
全球住院兒童超說明書用藥現狀的系統評價
下一篇
伊布利特與胺碘酮轉復房顫, 房撲效果的Meta分析

《中國循證醫學雜志》

西莫羅斯洗脫支架與裸支架治療ST段升高的急性心肌梗死隨機對照試驗的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

西莫羅斯洗脫支架與裸支架治療ST段升高的 急性心肌梗死隨機對照試驗的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

西莫羅斯洗脫支架與裸支架治療ST段升高的急性心肌梗死隨機對照試驗的Meta分析

摘要全文圖表視頻參考文獻施引文獻補充材料