The Efficacy And Safety Of Thrombus Aspiration Plus Tirofiban Administrated Via Aspiration Catheters In STEMI:a Meta-analysis Of RCTs

Objective: Evaluating the efficacy and safety of thrombus aspiration combined with tirofiban injection via aspiration catheter in treatment of the patients of STEMI during PCI.Methods: By searching PubMed,Web of Science and other online databases,to collect RCTs which published before the end of October 2020,concerning the comparison of that thrombus aspiration whether or not combined with tirofiban injection via aspiration catheter during PCI about efficacy and safety in treatment of patients with STEMI,we evaluated the quality of these RCTs,extracted the data and performed statistical analysis.Results: Six RCTs were included in our study.By using Rev Man5.3 software,the meta-analysis was performed.It showed that,compared with thrombus aspiration,injecting tirofiban via aspiration catheter for STEMI significantly reduced the rate of major adverse cardiac events(RR=0.48;95% CI: 0.30-0.77;P =0.003),the risk of the partial regression and no regression of ST segment was reduced(RR=0.66;95% CI:0.50-0.88;P =0.004).The incidence of postoperative slow blood flow and no-reflow phenomenon was also reduced(RR=0.24;95% CI: 0.08-0.68;P =0.008).The all-cause mortality rate showed a downward trend,but it did not reach the statistical difference(RR=0.33;95% CI: 0.10-1.08;P =0.07).Besides,there was also no significant difference in the incidence of bleeding events(RR=1.11;95% CI: 0.59-2.08;P =0.75).Conclusion: For STEMI who have heavy thrombus load,thrombus aspiration combined with tirofiban injection through aspiration catheter may reduce myocardial ischemia and injury by improving myocardial microcirculation,with significant efficacy and good safety.