TY - JOUR
T1 - Late myocardial reperfusion in ST-elevation myocardial infarction
T2 - Protocol for a systematic review and meta-analysis
AU - Vargas-Fernández, Rodrigo
AU - Chacón-Diaz, Manuel
AU - Basualdo-Meléndez, Gianfranco W.
AU - Barón-Lozada, Francisco A.
AU - Visconti-Lopez, Fabriccio J.
AU - Comandé, Daniel
AU - Hernández-Vásquez, Akram
N1 - Publisher Copyright:
©
PY - 2022/9/14
Y1 - 2022/9/14
N2 - Introduction ST-segment elevation myocardial infarction (STEMI) is the most severe clinical form of acute myocardial infarction, for which the current treatment consists of effective and timely myocardial reperfusion (within 12 hours of symptom onset). However, between 10% and 15% of patients with STEMI arrive at hospital facilities 12 hours after the onset of symptoms (late presentation). Therefore, the objective of the present study will be to determine if late revascularisation (12-72 hours after the onset of symptoms) affects the indicators of cardiovascular mortality, reinfarction, recurrent infarction, hospitalisation for heart failure and post infarction angina compared with no late revascularisation in patients with STEMI. Methods and analysis A systematic literature search of PubMed, The Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus and Global Health will be conducted. Publications in English, Portuguese or Spanish that report the clinical results of primary percutaneous revascularisation (primary PCI) in adult patients with STEMI 12-72 hours after the onset of symptoms will be included. Studies with participants with a diagnosis other than STEMI or patients with STEMI of >12 hours complicated by heart failure, cardiogenic shock or ventricular arrhythmias, and studies of combined interventions (pharmacoinvasive strategy) were excluded. Two independent authors will identify the relevant publications, and discrepancies will be adjudicated by a third author. Data extraction will be performed by two independent authors and verified by a third author. Risk of bias of studies will be assessed using the Cochrane risk of bias' tool (RoB 2) or Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. If appropriate, a meta-analysis will be performed in order to examine the effect of late revascularisation in clinical outcomes of interest. Ethics and discussion This study will use published data only, thus, ethical approval will not be required. The results will be disseminated through peer-reviewed publication and conference presentations. PROSPERO registration number CRD42021283429.
AB - Introduction ST-segment elevation myocardial infarction (STEMI) is the most severe clinical form of acute myocardial infarction, for which the current treatment consists of effective and timely myocardial reperfusion (within 12 hours of symptom onset). However, between 10% and 15% of patients with STEMI arrive at hospital facilities 12 hours after the onset of symptoms (late presentation). Therefore, the objective of the present study will be to determine if late revascularisation (12-72 hours after the onset of symptoms) affects the indicators of cardiovascular mortality, reinfarction, recurrent infarction, hospitalisation for heart failure and post infarction angina compared with no late revascularisation in patients with STEMI. Methods and analysis A systematic literature search of PubMed, The Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus and Global Health will be conducted. Publications in English, Portuguese or Spanish that report the clinical results of primary percutaneous revascularisation (primary PCI) in adult patients with STEMI 12-72 hours after the onset of symptoms will be included. Studies with participants with a diagnosis other than STEMI or patients with STEMI of >12 hours complicated by heart failure, cardiogenic shock or ventricular arrhythmias, and studies of combined interventions (pharmacoinvasive strategy) were excluded. Two independent authors will identify the relevant publications, and discrepancies will be adjudicated by a third author. Data extraction will be performed by two independent authors and verified by a third author. Risk of bias of studies will be assessed using the Cochrane risk of bias' tool (RoB 2) or Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. If appropriate, a meta-analysis will be performed in order to examine the effect of late revascularisation in clinical outcomes of interest. Ethics and discussion This study will use published data only, thus, ethical approval will not be required. The results will be disseminated through peer-reviewed publication and conference presentations. PROSPERO registration number CRD42021283429.
KW - CARDIOLOGY
KW - Coronary heart disease
KW - Coronary intervention
KW - Ischaemic heart disease
KW - Myocardial infarction
KW - Meta-Analysis as Topic
KW - Humans
KW - Myocardial Reperfusion
KW - Systematic Reviews as Topic
KW - Heart Failure
KW - Adult
KW - Percutaneous Coronary Intervention/methods
KW - ST Elevation Myocardial Infarction
UR - http://www.scopus.com/inward/record.url?scp=85137907433&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-059610
DO - 10.1136/bmjopen-2021-059610
M3 - Artículo de revisión
C2 - 36104139
AN - SCOPUS:85137907433
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e059610
ER -
