The Safety Of Rescue PCI VS Repeat Thrombolysis VS Conservative Therapy In Patients Failed Thrombolysis

Objective:To evalute and compare the benefit and the safety of Rescue PCI VS Repeat t hrombolysis VS Conservative therapy in patients failed thrombolysis.Methods:Seach of The Cochrance Library Pubmed CBM-disk CNKI and OVID for rando mized controlled trials comparing Rescue PCI VS Repeat thrombolysis VS Conserva tive therapy.Outcomes of interest assessed by adjusted indirect Meta-analysis:mortalit y,reinfarction,reperfusion,et al.Results:Eight trials were included(1177 patients).NO significant difference was found fo r mortality.Compared with Conservative therapy,Thromboembolic stroke,Bleeding adv erse significant in Rescue PCI[RR=4.39,95%CI( 1.14,16.87);RR=2.79,95%CI(1.55,5.02)],but they were no significant difference in a long term[P=0.23,RR=1.82,95%CI(0.68,4.86);P=0.11,RR=2.62,95%CI(0.80,8.55)]. Reinfarction decreased significantly i n Rescue PCI[P=0.05,RR=0.53,95%CI( 0.28,1.00);P=0.05,RR=0.60,95%CI( 0.28,1.01)],but it was no significant difference in a long term[P=0.32,RR=0.74,95%CI(0.41,1.34)].Revascularization decreased significant in Rescue PCI [RR=0.52,95%CI(0.38~0.73);RR=0.52,95%CI(0.38~0.70);RR=0.43,95%CI(0.27~0.66)].No significant difference was found for severe heart failure in Rescue PCI. Compared with Conservative ther apy, Reperfusion,Improvement of left heatt function,Bleeding adverse significant inRepeat thrombolysis[RR=2.19,95%CI(1.38,3.47);RR=0.10,95%CI(0.01~0.19);RR=1.89,95%CI( 1.15,3.10)]. No significant difference was found for severe heart failure, thro mboembolic stroke in Repeat thrombolysis[RR=0.90,95%CI( 0.40,2.06);RR=0.99,95%CI( 0.06,15.72)]. Compared with Repeat thrombolysis,reinfarction,bleeding,revascular ization decreased significant in Repeat thrombolysis[RR=0.20,95%CI(0.06~0.67);RR=2.15,95%CI(1.27~3.63);RR=0.57,95%CI(0.34~0.95);RR=0.60,95%CI(0.39~0.93)],No signif icant difference was found for severe heart failure, thromboembolic stroke in Rescu e PCI [RR=0.69,95%CI( 0.27,1.76);RR=2.96,95%CI( 0.31,28.10)].Conclusion:They can not decreased mortality, compared with Conservative therapy,Revascula rization decreased significant in Rescue PCI,compared with Conservative therapy,Rep erfusion,Improvement of left heatt function adverse significant in Repeat thrombolysi s,with the continuous improvement of antithrombotic drugs and interventional devices, t he efficacy of r PCI and RT needs further study.