替罗非班对非ST段抬高型急性冠脉综合征疗效与安全性的Meta分析

赵立志; 苟冬梅

doi:10.13201/j.issn.1001-1439.2016.10.008

替罗非班对非ST段抬高型急性冠脉综合征疗效与安全性的Meta分析

赵立志,
苟冬梅^,

- 西南医科大学附属中医院心脑病科(四川泸州, 646000)

详细信息

通讯作者: 苟冬梅,E-mail:493277527@qq.com

中图分类号: R542.2

收稿日期: 2016-04-07

Efficacy and safety of tirofiban in patients with non-ST segment elevation acute coronary syndromes:a Meta-analysis

ZHAO Lizhi,
GOU Dongmei^,

- Department of Cardiology, The Traditional Chinese Medicine Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China

More Information

Corresponding author: GOU Dongmei, E-mail: 493277527@qq.com

Received Date: 07 April 2016

摘要

摘要: 目的:评价替罗非班治疗非ST段抬高型急性冠脉综合征的疗效与安全性。方法:计算机检索PubMed及Ovid数据库,检索时间截止至2016年03月,收集关于替罗非班治疗非ST段抬高型急性冠脉综合征的研究,由2名评价者按照纳入和排除标准独立选择文献、提取资料、评价质量、交叉核对并进行方法学质量评估,采用Stata11.0统计软件进行Meta分析。结果:最终纳入19篇文献,包括8 582例非ST段抬高型急性冠脉综合征患者。主要终点指标显示,替罗非班对患者总死亡率无明显影响(RR=0.80,95%CI:0.64~1.01,P=0.066)。次要终点指标显示,替罗非班可以减少患者主要心血管不良事件的发生率,不管是在院内随访期间(RR=0.76,95%CI:0.61~0.96,P=0.018),30d随访期间(RR=0.71,95%CI:0.59~0.85,P=0.000),还是3个月及以上的随访期间(RR=0.65,95%CI:0.48~0.86,P=0.003)。安全性终点指标显示,与对照组比较,替罗非班可增加患者的出血风险(RR=1.31,95%CI:0.13~1.51,P=0.000)。结论:替罗非班并不能降低非ST段抬高型急性冠脉综合征患者的总死亡率,但可以减少主要心血管不良事件的发生率,同时可增加出血风险,但在纳入文献中并未观察到致命性出血的发生。
- 替罗非班 /
- 急性冠脉综合征 /
- 非ST段抬高型 /
- Meta分析
Abstract: Objective:To evaluate the efficacy and safety of tirofiban in patients with non-ST segment elevation acute coronary syndromes(NSTE ACS).Method:The randomized controlled trials(RCTs)and cohort studies were searched from PubMed and Ovid until Mar 2016.According to the inclusion and exclusion criteria,2reviewers independently selected and extracted data,then evaluated the quality,cross-checked and evaluated the quality of the methodology.Stata 11.0was used to perform Meta-analysis.Result:A total of 19 documents with 8 582 patients were finally enrolled.The primary endpoint showed that,there was no difference in all-cause mortality betweenNSTE ACS patients treated with tirofiban compared with those treated with placebo or others(RR=0.80,95%CI:0.64-1.01,P=0.066).The second endpoint showed that tirofiban reduced the occurrence of the composite of major adverse cardiovascular events(MACE)both in-hospital follow-up(RR=0.76,95%CI:0.61-0.96,P=0.018),30-day follow-up(RR=0.71,95%CI:0.59-0.85,P=0.000)and 3-month follow-up(RR=0.65,95%CI:0.48-0.86,P=0.003).The safety endpoint showed tirofiban was associated with higher bleeding risk(RR=1.31,95%CI:0.13-1.51,P=0.000),but no fatal bleeding was observed.Conclusion:Tirofiban provide no significant benefit on all-cause mortality in NSTE ACS patients,but it can reduce the incidence of MACE,and can increase the risk of non fatal bleeding.Tirofiban can effectively and safely improve the prognosis of NSTE ACS patients.
- tirofiban /
- acute coronary syndromes /
- non-ST segment elevation /
- Meta-analysis

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