| Objective(s):To evaluate the medical efficacy and security of alprostadil in preventing and treating no-reflow after Percutaneous Coronary Intervention(PCI).Method(s): The Cochrane Library clinical controlled trial database,Pub Med,EMBASE,CBMdisc,Google Scholar,CNKI,Wanfangdata,and CQVIP were searched.Two evaluators independently evaluated the quality of the included studies,extracted data,and cross-checked the references.Then,Rev Man5.4 was used for meta-analysis of homogeneity.Result(s): 11 studies involving 913 cases were included in this analysis.The results of the meta-analysis showed that alprostadil significantly improved the TIMI flow [(RR = 0.37,95%CI =(0.26,0.51)],corrected TIMI Frame Count(CTFC)[WMD =-4.89,95%CI =(-7.36,-2.43)],TIMI Myocardial Perfusion Grading(TMPG)[WMD =-4.89,95%CI =(-7.36,-2.43)],Myocardial Blush Grade(MBG)[RR = 0.50,95%CI =(0.38,0.67)],and reduced incidence of Slow-flow/No-reflow Phenomenon.Additionally,alprostadil significantly improved the Left Ventricular Ejection Fraction(LVEF)six months after PCI[WMD = 4.28,95%CI =(2.49,6.06)] and reduced the incidence rates of Major Adverse Cardiac Events(MACEs)during hospitalization,three months and six months after PCI [RR = 0.46,95%CI =(0.25,0.84)].Conclusion(s): This systematic analysis shows that alprostadil can decrease the incidence of Slow-flow/No-reflow,MACEs,CTFC,TMPG,and LVEF after PCI and post-surgery.However,due to the methodological limitations of the included studies,high-quality RCT with a large sample size is required to prove its efficacy and safety. |
