Meta-analysis Of The Efficacy And Safety Of Intracoronary Administration Of Tirofiban For No-reflow Phenomenon

Objective:The aim of this meta-analysis was to evaluate the efficacy and safety of intracoronary(IC) administration of tirofiban compared with other conventional drugs during percutaneous coronary intervention(PCI) for no-reflow(NR).Methods:A search was retrieved from Cochrane Library, Pubmed, EMbase, Chinese Biomedical Literature Database(CBM), Chinese Journal Full-text Database(CNKI),Wanfang to systematically collect the randomized controlled trials of intracoronary administration of tirofiban versus other conventional drugs for NR undergoing PCI. The data was extracted from the included studies and analyzed by Cochrane Collaboration’s Rev Man5.3 software.Results:Eleven randomized clinical trials with 749 patients were included. Significantly, the treatment of tirofiban was more effective in improving the thrombolysis in myocardial infarction(TIMI) 3 flow(OR=0.26, 95%CI[0.19-0.35], P<0.00001) and reducing major adverse cardiovascular events(MACE)(OR=0.12, 95%CI[0.07-0.21], P<0.00001). There was a trend to increase the risk of bleeding, but the data of the result did not reach the statistical significance(OR=1.68, 95%CI[0.81-3.49], P=0.16).Conclusion:Tirofiban is more effective than conventional drugs for NR during PCI, but the potential risk of bleeding complication induced by tirofiban shouldn’t be ignored during clinical practices.