Volume 21 Issue 10
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(10): 1783-1788
LI Qiuyan, HE Shirong, SU Qiang. Systematic evaluation and meta-analysis of intracoronary injection of epinephrine for preventing no-reflow after PCI[J]. Chinese Journal of General Practice, 2023, 21(10): 1783-1788. doi: 10.16766/j.cnki.issn.1674-4152.003224
Citation: LI Qiuyan, HE Shirong, SU Qiang. Systematic evaluation and meta-analysis of intracoronary injection of epinephrine for preventing no-reflow after PCI[J]. Chinese Journal of General Practice, 2023, 21(10): 1783-1788. doi: 10.16766/j.cnki.issn.1674-4152.003224
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Systematic evaluation and meta-analysis of intracoronary injection of epinephrine for preventing no-reflow after PCI

doi: 10.16766/j.cnki.issn.1674-4152.003224

  • Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541000, China

Funds:

 桂科AB20159005

  • Received Date: 2023-01-17
    Available Online: 2023-11-23
    Abstract
  •   Objective  To systematically evaluate the effectiveness and safety of epinephrine in the prevention and treatment of no-reflow after percutaneous coronary intervention (PCI), and to provide a further basis for clinical management.  Methods  The Cochrane Controlled Trials Database, PubMed, EMbase, China Biology Medicine disc, Wanfang Database and China National Knowledge Infrastructure were searched for relevant literature on no-reflow and slow flow after PCI since the establishment of the database to July 2022, and the inclusion and exclusion criteria were strictly followed to screen, extract, check and final meta-analysis was performed using RevMan 5.3 software.  Results  A total of 5 studies were selected, with a combined total of 527 patients. The final analysis showed that intracoronary epinephrine injection significantly improved thrombolysis in myocardial infarction trial (TIMI) flow and reduced the incidence of no/slow flow phenomenon (RR=0.52, 95% CI: 0.37-0.72, P < 0.001). Meanwhile, in terms of adverse effects, epinephrine significantly reduced the incidence of intraoperative hypotension during PCI, and the difference between the two groups was statistically significant (P < 0.05). However, for the effects of post-PCI corrected TIMI frame count (CTFC), myocardial blush grade (MBG), incidence of major adverse cardiovascular events (MACEs) during hospitalization and 30 days post-PCI, and post-PCI left ventricular ejection fraction (LVEF), the differences between the two groups were not statistically significant (all P>0.05). A subgroup analysis based on different control groups for TIMI blood flow, CTFC after PCI showed that the results of the difference between epinephrine and different control groups were similar to those before the subgroup analysis and were not statistically significant.  Conclusion  The results of this systematic evaluation show that intracoronary injection of epinephrine may have the effect of reducing the incidence of no-reflow/slow flow after PCI and that the incidence of intraoperative hypotension is lower than that of drugs such as verapamil and nitroprusside. However, due to the limitations of the study, further confirmation is needed by including randomized controlled trials with larger sample sizes

     

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