DOES PERIPROCEDURAL NICORANDIL IMPROVE CARDIOVASCULAR OUTCOMES IN ACUTE MYOCARDIAL INFARCTION? - META-ANALYSIS

Background: Metabolic modulation of ischemic myocardium using a glucose-insulin-potassium (GIK) infusion has been studied in patients with acute myocardial infarction treated with reperfusion therapy, but the results have been conflicting. We conducted a systematic review and meta-analysis of randomized placebo-controlled trials evaluating the utility of GIK in the prevention of adverse cardiovascular outcomes in patients with acute myocardial infarction who underwent reperfusion therapy. Methods: A total of 19,222 patients from 6 randomized placebo-controlled clinical trials were analyzed using pooled meta-analysis techniques, and relative risks at the end of one month were computed for various adverse cardiovascular outcomes. Statistical significance was determined using the z -test (two-sided alpha-error <0.05). Results: The use of GIK did not significantly reduce the risk of death within the first month among patients with acute myocardial infarction treated with reperfusion therapy (p=0.40), and did not differ among those treated with thrombolytic agents (p=0.54) or those treated with primary coronary angioplasty (p=0.38). The risk of re-infarction within the first month was also not significantly reduced (p=0.32), nor were the risk of development of heart failure (p=0.40) or the need for invasive coronary revascularization (p=0.76). Conclusions: Among patients with acute myocardial infarction who are treated with reperfusion therapy, the use of GIK infusion has no significant effect on mortality or the occurrence of adverse cardiovascular events within the first month.

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Newly Discovered Abnormal Glucose Tolerance in Patients With Acute Myocardial Infarction and Cardiovascular Outcomes: A Meta-analysis

Diabetes Care ◽

10.2337/dc20-0059 ◽

2020 ◽

Vol 43 (8) ◽

pp. 1958-1966

Author(s):

Nitchakarn Laichuthai ◽

Muhammad Abdul-Ghani ◽

Mikhail Kosiborod ◽

Wasita Warachit Parksook ◽

Stephen J. Kerr ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Glucose Tolerance ◽

Meta Analysis ◽

Cardiovascular Outcomes ◽

Abnormal Glucose Tolerance

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Faculty Opinions recommendation of Intra-aortic Balloon Pump Therapy for Acute Myocardial Infarction: A Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725411004.793508710 ◽

2015 ◽

Author(s):

André Coetzee

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Meta Analysis ◽

Pump Therapy ◽

Intra Aortic Balloon Pump

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Faculty Opinions recommendation of Effect of losmapimod on cardiovascular outcomes in patients hospitalized with acute myocardial infarction: A randomized clinical trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726263950.793523565 ◽

2016 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Cardiovascular Outcomes

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Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044564 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044564

Author(s):

Kaizhuang Huang ◽

Jiaying Lu ◽

Yaoli Zhu ◽

Tao Cheng ◽

Dahao Du ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Risk Factor ◽

Meta Analysis ◽

Coronary Intervention ◽

Cochrane Library ◽

Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

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