Meta-analysis about the efficacy and safety of early administration of tirofiban in Chinese STEMI patients

Yi Tie-Ci;Weng Hao-Yu;Li Jian-ping;Huo Yong;Department of Cardiology,Peking University First Hospital;  

Objective To assess the efficacy and safety of early use of tirofiban in Chinese population of ST segment elevated myocardial infraction( STEMI) patients receiving primary percutaneous intervention( PCI). Methods We searched English and Chinese databases for articles published before September 30, 2016. The Primary endpoints were the rate of TIMI blood flow grade Ⅲbefore and after intervention. The secondary end point was death and major adverse cardiovascular events(MACE) during hospitalization and in 30 days. The safety end point was bleeding and severe bleeding events during hospitalization. Results 29 studies were included in this study. 3248 subjects were involved. The two groups were similar in baseline characterize. Early use of tirofiban significantly increased the rate of TIMI blood flow grade Ⅲ both before and after operation( before operation : RR2.36, 95% CI 1. 96 ～2. 84,P 0. 00001; after operation: RR 1. 07, 95% CI 1. 04 ～ 1. 09, P 0.00001). There was no significant difference in the mortality during hospitalization between the two groups. However, early initiation of tirofiban showed a trend of lower MACE during hospitalization and a significant reduction of MACE events within 30 days. There was no significant difference in safety events between the two groups(bleeding: RR1.10, 95% CI 0.90 ～ 1.36, P=0.35; major bleeding: RR 1.44,95%CI 0.67 ～3.11, P 0.35). Conclusion Early application of tirofiban can improve preoperative and postoperative blood perfusion in Chinese STEMI patients without increasing the risk of bleeding.

【CateGory Index】： R542.22

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