Most Read Articles
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
11 Aug 2019
Treatment with low-to-standard dose dual combination therapy of blood pressure (BP)-lowering drugs is more effective than standard-dose monotherapy and does not increase withdrawals due to adverse events, a recent study has shown.
20 Jun 2019
Untreated white coat hypertension (WCH), but not treated white coat effect (WCE), may increase the risk for cardiovascular events and all-cause mortality, suggest the results of a systematic review and meta-analysis. Out-of-office blood pressure (BP) monitoring is thus important in the diagnosis and management of hypertension.
06 Aug 2019
Risk factors for 1-year mortality in heart failure (HF) patients significantly differ between those with and without chronic kidney disease (CKD), especially with regard to the use of beta-blockers or diuretics at discharge, according to a study. This suggests that these patients may benefit from individualized therapies.

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
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
11 Aug 2019
Treatment with low-to-standard dose dual combination therapy of blood pressure (BP)-lowering drugs is more effective than standard-dose monotherapy and does not increase withdrawals due to adverse events, a recent study has shown.
20 Jun 2019
Untreated white coat hypertension (WCH), but not treated white coat effect (WCE), may increase the risk for cardiovascular events and all-cause mortality, suggest the results of a systematic review and meta-analysis. Out-of-office blood pressure (BP) monitoring is thus important in the diagnosis and management of hypertension.
06 Aug 2019
Risk factors for 1-year mortality in heart failure (HF) patients significantly differ between those with and without chronic kidney disease (CKD), especially with regard to the use of beta-blockers or diuretics at discharge, according to a study. This suggests that these patients may benefit from individualized therapies.