Meta-Analysis Of The Effect Of Thrombus Aspiration Combined With PCI And PCI Alone On Stroke Rate In Patients With Acute ST-Segment Elevation Myocardial Infarction

Objective :To evaluate the effect of thrombus aspiration on stroke rate in patients with acute ST-segment elevation myocardial infarction.Methods:The computer retrieved the self-built library to a randomized controlled trial(RCT)literature on thrombus aspiration combined with PCI and simple PCI in Pubmed,CNKI,and Wanfang database in January 2019.According to the inclusion and exclusion criteria,literature screening,data extraction,and selection of the selected literature,the quality of the selected literature was evaluated using the Cochrane Rating Scale.Statistical analysis was performed using Review Manager 5.3 for meta-analysis.Results:A total of 13789 prospective randomized controlled trials were included,with a total of 19,789 patients,which were 9904 in the experimental group(TA+PCI group)and 9885 in the control group(single PCI group).The admission of patients to hospital for 30 days was defined as short-term,6 to 9 months for the medium term,and 1 year and longer for the long term;the analysis of these 13 trials showed that there was a significant correlation between TA and the risk of short-term and long-term stroke.Sex,the short-term stroke rate(RR=1.48,95% CI=1.01~2.17,P=0.04)and long-term stroke rate(RR=1.64,95% CI=1.10~2.43,P=0.02)were significantly higher in the study group.In the control group,the mid-term stroke rate(RR=2.42,95% CI=0.48~12.31,P=0.29)did not increase in the TA group;the short-term stroke rate in the TA group with an average GPI usage of less than 50%(RR=1.48,95)The short-term stroke rate(RR=1.49,95%CI=0.61~3.61,P=0.38)of the TA group with %CI=0.97~2.27,P=0.07)and GPI average utilization rate greater than 50% did not increase significantly;thrombus load 5 The short-term stroke rate(RR=1.90,95% CI=1.12~3.22,P=0.02)of the TA group with grade or integral ≥4 accounted for more than 50% increased,while the thrombus load level 5 or the score ≥4 accounted for less than 50% of the TA There was no increase in the short-term stroke rate(RR=1.13,95% CI=0.64-1.97,P=0.68).Conclusions:(1)Thrombosis is one of the independent risk factors for short-term and long-term stroke in patients with STEMI after PCI.(2)There may be a negative correlation between GPI usage and the incidence of stroke.(3)High thrombus burden is highly correlated with the occurrence of stroke.