Most Read Articles
Christina Lau, 02 Jan 2020

Tolvaptan improves dyspnoea, increases sodium levels and reduces body weight in patients with acute heart failure (HF) with or without hyponatraemia, but no significant effect is seen in mortality or rehospitalization, according to a recent meta-analysis.

Pearl Toh, 15 Apr 2020
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic stenosis who are at low surgical risk appears to be safe with low rates of death or disabling stroke at 30 days, according to a study presented at the ACC.20/WCC Virtual Meeting.

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.

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Most Read Articles
Christina Lau, 02 Jan 2020

Tolvaptan improves dyspnoea, increases sodium levels and reduces body weight in patients with acute heart failure (HF) with or without hyponatraemia, but no significant effect is seen in mortality or rehospitalization, according to a recent meta-analysis.

Pearl Toh, 15 Apr 2020
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic stenosis who are at low surgical risk appears to be safe with low rates of death or disabling stroke at 30 days, according to a study presented at the ACC.20/WCC Virtual Meeting.