Intracoronary thrombolysis facilitated primary percutaneous coronary intervention in ST-segment elevation myocardial infarction patients: an updated meta-analysis of randomized controlled trials

Abstract Background Primary percutaneous coronary intervention (PPCI) is the standard reperfusion treatment in ST-segment elevation myocardial infarction (STEMI). However, PPCI often complicated by microvascular obstruction. Intracoronary thrombolysis (ICT) may mitigate thrombotic burden. Methods We conducted, according to PRISMA statement, largest meta-analysis of ICT as adjuvant therapy PPCI. All relevant studies were identified searching PubMed, Scopus, Cochrane Library, and Web Science, with no time or language restriction. The odds ratio (OR) mean difference (MD) a 95% confidence interval (CI) calculated. Studies included STEMI patients undergoing receiving ICT. Both safety efficacy outcomes analyzed. Data combined using random-effects model. Results Thirteen randomized controlled trials (RCTs) involving total 1876 (1014 ICT) included. Compared control group, could reduce incidence major adverse cardiac events (MACE) (OR 0.65, CI, 0.48–0.86, P=0.003) improve 6 months left ventricular ejection fraction (MD 3.78, 1.53–6.02, P=0.0010). Indices enhanced microcirculation more common [Post PCI corrected (TIMI) frame count −3.57; −5.00 −2.14, P<0.00001); blush grade (MBG) 2/3 1.76; 1.16–2.69, P=0.008), complete resolution 1.97; 1.33–2.91, P=0.0007). rate bleeding was comparable between 2 groups 1.27; 0.61–2.63, P=0.53). Conclusions associated improved MACE PPCI, without any significant increase bleeding. Our suggests that targeted safe potentially effective Nonetheless, above results necessitate verification contemporary large RCT. Funding Acknowledgement Type funding sources: None.