Bivalirudin versus heparin in patients planned for percutaneous coronary intervention: a meta-analysis of randomised controlled trials

The Lancet ◽  
2014 ◽  
Vol 384 (9943) ◽  
pp. 599-606 ◽  
Author(s):  
Matthew A Cavender ◽  
Marc S Sabatine
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Controlled Trials ◽  
Percutaneous Coronary ◽  
Randomised Controlled

scholarly journals Effect of N-acetylcysteine on prevention of contrast-associated acute kidney injury in patients with STEMI undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039009
Author(s):  
Zhaodong Guo ◽  
Jin Liu ◽  
Li Lei ◽  
Yan Xue ◽  
Liwei Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Controlled Trials ◽  
Percutaneous Coronary ◽  
Randomised Controlled

ObjectiveSeveral studies evaluating the preventive effect of N-acetylcysteine (NAC) on contrast-associated acute kidney injury (CA-AKI) among patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) have suggested inconsistent results and that a systematic review and meta-analysis should be performed.DesignSystematic review and meta-analysis.Data sourcesPubMed, MEDLINE, EMBASE, ClinicalTrials.gov and the Cochrane Central databases were searched from inception to 15 November 2019.Eligibility criteriaRandomised controlled trials assessing use of NAC compared with non-use of NAC (eg, placebo) in preventing CA-AKI in patients with STEMI following PPCI were included.Data synthesisRelative risks with 95% CIs were pooled using a random-effects model. Evidence level of conclusions was assessed by Cochrane GRADE measure.ResultsSeven trials including 1710 patients were identified. Compared with non-use of NAC, use of NAC significantly reduced the incidence of CA-AKI by 49% (risk ratio (RR) 0.51, 95% CI 0.31 to 0.82, p<0.01) and all-cause in-hospital mortality by 63% (RR 0.37, 95% CI 0.17 to 0.79, p=0.01). The estimated effects on the requirement for dialysis (RR 0.61, 95% CI 0.11 to 3.38, p=0.24) were not statistically significant. Trial sequential analysis confirmed the true positive of NAC in reducing risk of CA-AKI. Subgroup analyses suggested that the administration of NAC had greater benefits in patients with renal dysfunction and in those receiving oral administration and higher dosage of NAC.ConclusionsNAC intake reduces the risk of CA-AKI and all-cause in-hospital mortality in patients with STEMI undergoing PPCI. The estimated potential benefit of NAC in preventing dialysis was ambiguous, and further high-quality studies are needed.PROSPERO registration numberCRD42020155265.

scholarly journals Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023096 ◽  
Author(s):  
Chuanjin Luo ◽  
Junmao Wen ◽  
Weipeng Sun ◽  
Ting Li ◽  
Xiaojiang Yu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trials ◽  
Tai Chi ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Percutaneous Coronary ◽  
Randomised Controlled

IntroductionCoronary heart disease (CHD) is the most common cause of death worldwide. Percutaneous coronary intervention (PCI) has been shown to reduce mortality in patients with CHD. However, there are still recurrences of cardiovascular events after PCI. Cardiac rehabilitation (CR) in patients with established CHD is associated with reductions in cardiovascular mortality and hospital admissions, as well as improved quality of life. More and more clinical trials suggest that traditional Chinese exercise (TCE) plays a positive role in patients post-PCI. The primary purposes of the current study are to conduct a network meta-analysis of randomised trials to determine the effects of TCE in patients after PCI, and to separately compare the effects of tai chi, baduanjin and yijinjing on CR after PCI.Methods and analysisStudies will be retrieved from the following databases: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data, Chinese BioMedical Database and Chinese Science and Technology Periodicals Database, from inception to December 2018. We will include randomised controlled trials that are related to the effects of TCE therapies in patients after PCI. The primary outcomes will be all-cause mortality, revascularisations, health-related quality of life and hospitalisations. Two reviewers will independently select eligible articles. For each included article, two reviewers will independently extract the data and assess the risk of bias by using the Cochrane risk of bias tool. Bayesian network meta-analyses will be conducted to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (tai chi, baduanjin or yijinjing) will be estimated by the mean ranks and surface under the cumulative ranking curve. The Grading of Recommendations Assessment, Development and Evaluation System will be used to assess the quality of evidence.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. They will provide consolidated evidence to inform clinicians on the potential functions of TCE in CR, and to provide reliable evidence for the application of TCE.Trial registration numberCRD42018088415.

Sign in / Sign up

Export Citation Format

Share Document