Evidence map›Paper›PMID 38925881›Full record

SynthesisHeart (British Cardiac Society)2024

Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis.

Rajan Rehan, Sohaib Virk, Christopher C Y Wong, Freda Passam, Jamie Layland, Anthony Keech, Andy Yong, Harvey D White, William Fearon, Martin Ng

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Heart (British Cardiac Society), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rajan RehanRoyal Prince Alfred Hospital, Camperdown, New South Wales, Australia.ORCID 0000-0002-3678-2855
Sohaib VirkSystematic Reviews, CORE Group, Sydney, New South Wales, Australia.ORCID 0000-0002-7235-3919
Christopher C Y WongCardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.ORCID 0000-0002-0180-0072
Freda PassamDepartment of Hematology, University of Sydney, Sydney, New South Wales, Australia.
Jamie LaylandMonash University, Melbourne, Victoria, Australia.
Anthony KeechNHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
Andy YongCardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Harvey D WhiteCardiology Department, Green Lane Cardiovascular Service and Green Lane Cardiovascular Research Unit, Auckland City Hospital, Auckland, New Zealand.ORCID 0000-0001-7712-6750
William FearonStanford University, Stanford, California, USA.
Martin NgRoyal Prince Alfred Hospital, Camperdown, New South Wales, Australia Martin.ng@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite restoration of epicardial blood flow in acute ST-elevation myocardial infarction (STEMI), inadequate microcirculatory perfusion is common and portends a poor prognosis. Intracoronary (IC) thrombolytic therapy can reduce microvascular thrombotic burden; however, contemporary studies have produced conflicting outcomes.

objectivesThis meta-analysis aims to evaluate the efficacy and safety of adjunctive IC thrombolytic therapy at the time of primary percutaneous coronary intervention (PCI) among patients with STEMI.

methodsComprehensive literature search of six electronic databases identified relevant randomised controlled trials. The primary outcome was major adverse cardiac events (MACE). The pooled risk ratio (RR) and weighted mean difference (WMD) with a 95% CI were calculated.

results12 studies with 1915 patients were included. IC thrombolysis was associated with a significantly lower incidence of MACE (RR=0.65, 95% CI 0.51 to 0.82, I

conclusionAdjunctive IC thrombolysis at the time of primary PCI in patients with STEMI improves clinical and myocardial perfusion parameters without an increased rate of bleeding. Further research is needed to optimise the selection of thrombolytic agents and treatment protocols.

Indexed as

Fibrinolytic AgentsPercutaneous Coronary InterventionST Elevation Myocardial InfarctionThrombolytic TherapyCoronary CirculationHumansMicrocirculationTreatment OutcomeFibrinolytic AgentsAcute Coronary SyndromeAtherosclerosisMeta-AnalysisMyocardial Infarction

Identifiers

PMID38925881
PMCPMC11287581

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.