Most Read Articles
Audrey Abella, 15 Oct 2018
Reducing salt intake is one of the most practical ways to help tackle hypertension, according to data presented at AFCC 2018.
Stephen Padilla, 09 Nov 2018
There appears to be a high burden of potentially modifiable risk factors among individuals within newly defined categories of hypertension (elevated blood pressure [BP] and stage 1 hypertension), according to a recent study. Such burden shows a progressive increase along the BP categories and represents potential targets for nonpharmacologic intervention.

Pharmacoinvasive therapy, PPCI confer comparable survival benefits to transfer STEMI patients

11 Sep 2018

Pharmacoinvasive therapy (PIT) and primary percutaneous coronary intervention (PPCI) are comparable in terms of all-cause mortality in transfer patients with ST-elevation myocardial infarction (STEMI), a recent meta-analysis has shown.

Seventeen studies were eligible for inclusion in the meta-analysis, of which six were randomized controlled trials (RCTs) and 11 were cohort studies. Together, the studies corresponded to 13.037 patients who received either PPCI (n=7,398) or PIT (n=5,693). No evidence of small study effects or publication bias was reported.

Pooled analysis of the six RCTs showed PIT and PPCI were statistically comparable in terms of all-cause, short-term (odds ratio [OR], 0.99; 95 percent CI, 0.73–1.34; p=0.93) and long-term (OR, 0.83; 0.59–1.17; p=0.287) mortality. On the other hand, PPCI significantly increased the risk of all-cause, short-term mortality, according to the pooled analysis of observational studies (OR, 1.39; 1.04–1.87; p=0.028).

However, combining both RCTs and observational studies demonstrated that both approaches resulted in similar likelihood of all-cause short-term (OR, 1.20; 0.97–1.49; p=0.099) and long-term (OR, 1.17; 0.84–1.62; p=0.361) mortality.

The same was true for total stroke (OR, 0.76; 0.51–1.49; p=0.193), haemorrhagic stroke (OR, 0.56; 0.20–1.62; p=0.288), ischaemic stroke (OR, 0.65; 0.28–1.49; p=0.310) and major bleeding (OR, 0.73; 0.48–1.11; p=0.138).

In contrast, PPCI significantly increased the risk of cardiogenic shock (OR, 1.48; 1.13–1.94; p=0.005) and decreased the chances of reinfarction (OR, 0.69; 0.49–0.97; p=0.033) relative to PIT.

The databases of Embase, Scopus, PubMed and the Cochrane Library were accessed for the present meta-analysis. Studies on facilitated PCI and with ischaemia-guided reperfusion were excluded. The Newcastle-Ottawa scale was used to evaluate study quality.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Audrey Abella, 15 Oct 2018
Reducing salt intake is one of the most practical ways to help tackle hypertension, according to data presented at AFCC 2018.
Stephen Padilla, 09 Nov 2018
There appears to be a high burden of potentially modifiable risk factors among individuals within newly defined categories of hypertension (elevated blood pressure [BP] and stage 1 hypertension), according to a recent study. Such burden shows a progressive increase along the BP categories and represents potential targets for nonpharmacologic intervention.