抗氧化剂普罗布考对冠心病介入后患者主要不良心血管事件的Meta分析
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(中国中医科学院西苑医院, 北京市 100091)

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崔源源,博士,主治医师,研究方向为冠心病介入治疗,E-mail为cuiyuanyuan59@yeah.net。通信作者赵福海,博士,主任医师,硕士研究生导师,研究方向为冠心病介入治疗,E-mail为13911134962@163.com。

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国家自然科学基金面上项目(81473530,81774139);中国中医科学院博士研究生创新人才培养基金项目 (CX201701)


Effect of antioxidant probucol on MACE in patients with coronary artery disease after percutaneous coronary intervention:a meta analysis
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Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing 100091, China)

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    摘要:

    目的 评价抗氧化剂普罗布考对改善冠心病介入后患者主要不良心血管事件(MACE)的作用。方法 检索PubMed、EMBASE、Science Direct和Cochrane 临床对照试验中心注册库(the cochrane central register of clinical trial)、中文学术期刊全文数据库(CNKI)和万方数据库(WFDP)等电子数据库进行检索。中英文检索词包括“抗氧化剂”或“普罗布考”或“维他命C”或“维他命E”或“N-乙酰半胱氨酸”和“血管成形术”或“支架”和“随机”。采用Cochrane协作网提供的RevMan5.3软件进行Meta分析。结果 在纳入的349篇文献中,有7篇文献对冠心病介入后患者发生MACE事件进行了报告,普罗布考组(n=352)发生MACE事件72例,发生率为20.5%;对照组(n=354)发生MACE事件111例,发生率为31.4%。与对照组比较,普罗布考组明显降低MAEC发生率(RR:0.5,5%CI 0.51~0.84, P=0.0008)。经进一步分析,与对照组比较,普罗布考组有52例患者发生再次血运重建事件,发生率为14.8%,显著低于对照组(86例,发生率为24.3%,95%CI 0.44~0.83,P=0.002)。两组再次心肌梗死和全因死亡率差异无显著性(P=0.34,P=0.49)。此外,与对照组比较,普罗布考组显著降低介入后患者总胆固醇和低密度脂蛋白水平(SMD -0.8,5%CI -0.87~-0.49,P<0.00001; SMD -0.8,5%CI -0.46~-0.11,P=0.001)。结论 与冠心病介入后常规治疗比较,抗氧化剂普罗布考联合常规治疗可明显降低MACE发生率,该作用与普罗布考降低再次血运重建,改善总胆固醇和低密度脂蛋白水平相关。

    Abstract:

    Aim To examine the effect of probucol on major advanced cardiovascular events (MACE) in patients with coronary artery disease undergone PCI. Methods Electronic databases, including PubMed, EMBASE, ScienceDirect and the Cochrane Central Register of clinical trial, CNKI database and Wan-Fang Database were used. The search items of“antioxidant”or“probucol” or “vitamin C”or “vitamin E” or “N-acetylcysteine”and “angioplasty”or “stent” and “randomized” were selected. RevMan 5.3 provided by the Cochrane was used to perform this analysis. Results In the enrolled 349 articles, there were 7 articles reporting MACE events in patients with coronary heart disease undergone PCI. There were 72 events in antioxidant group (72/2,0.5%). 111 events occurred in control group (111/4,1.4%). Compared to control group, antioxidant (probucol) group significantly decreased the incidence of MACE (RR 0.5,5%CI 0.51~0.84, P=0.0008). Compared with control group (86/2,4.3%), there was a lower rate of repeat revascularization in antioxidant group (52/2,4.8; RR 0.1,5%CI 0.44~0.83, P=0.002). No difference was observed in myocardial infarction death between groups (P=0.34,P=0.49). In addition, total cholesterol (TC) and low density lipoprotein- cholesterol (LDLC) were significantly decreased in probucol group when compared with control group (standard mean reduction SMD -0.8,5%CI -0.87~-0.49, P<0.00001; SMD -0.8,5%CI -0.46~-0.11, P=0.001, respectively). Conclusions Antioxidant probucol combined with conventional treatment significantly decreased the rate of MACE in patients with coronary artery disease undergone PCI. This benefit may be related to the improvement of repeat revascularization and lipid profile.

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崔源源,王欣,赵福海.抗氧化剂普罗布考对冠心病介入后患者主要不良心血管事件的Meta分析[J].中国动脉硬化杂志,2019,27(12):1045~1052.

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  • 收稿日期:2019-05-05
  • 最后修改日期:2019-05-27
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  • 在线发布日期: 2019-12-18