Effect of fibrinolytic therapy on ST-elevation myocardial infarction clinical outcomes during the COVID-19 pandemic:A systematic review and meta-analysis

作     者：Anwar Khedr Hussam Al Hennawi Muhammed Khuzzaim Khan Mostafa Elbanna Abbas B Jama Ekaterina Proskuriakova Hisham Mushtaq Mikael Mir Sydney Boike Ibtisam Rauf Aalaa Eissa Meritxell Urtecho Thoyaja Koritala Nitesh Jain Lokesh Goyal Salim Surani Syed A Khan 

作者机构：Department of Internal MedicineBronxCare Health SystemBronxNY 10457United States Department of Internal MedicineJefferson Abington HospitalAbingtonPA 19001United States Department of Internal MedicineDow University of Health ScienceKarachi 74200Pakistan Department of Internal MedicineRochester Regional HealthRochesterNY 14621United States Department of Critical CareMayo Clinic Health SystemMankatoMN 56001United States Department of Internal MedicineMount Sinai HospitalChicagoIL 60608United States Department of Internal MedicineSt.Vincent's Medical CenterBridgeportCT 06606United States Department of MedicineUniversity of MinnesotaMinneapolisMN 55455United States Department of MedicineSt.George's UniversitySchool of MedicineSt George SW170REGrenada Department of MedicineKFS UniversityKFS 33511Egypt Department of MedicineRobert D and Patricia E.Kern Center of Health Care DeliveryMayo ClinicRochesterMN 55905United States Department of Hospital MedicineMayo Clinic Health SystemMankatoMN 56001United States Department of MedicineMayo Clinic Health SystemMankatoMN 56001United States Department of Hospital MedicineChristus Sphon Hospital-shorelineCorpus ChristoTX 78404United States Department of PulmonaryCritical Care&Sleep MedicineTexas A&M UniversityCollege StationTX 77843United States Department of Critical Care MedicineMayo Clinic Health SystemMankatoMN 56001United States 

出 版 物：《World Journal of Cardiology》 (世界心脏病学杂志（英文版）（电子版）)

年 卷 期：2023年第15卷第6期

页      面：309-323页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：ST-elevation myocardial infarction Myocardial infarction Thrombolytic therapy Fibrinolysis COVID-19 Pandemics 

摘      要：BACKGROUND ST-elevation myocardial infarction(STEMI)is the result of transmural ischemia of the myocardium and is associated with a high mortality *** percutaneous coronary intervention(PPCI)is the recommended first-line treatment strategy for patients with *** timely delivery of PPCI became extremely challenging for STEMI patients during the coronavirus disease 2019(COVID-19)pandemic,leading to a projected steep rise in *** delays were overcome by the shift from first-line therapy and the development of modern fibrinolytic-based *** is unclear whether fibrinolytic-based reperfusion therapy is effective in improving STEMI *** To determine the incidence of fibrinolytic therapy during the COVID-19 pandemic and its effects on STEMI clinical *** PubMed,Google Scholar,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials were queried from January 2020 up to February 2022 to identify studies investigating the effect of fibrinolytic therapy on the prognostic outcome of STEMI patients during the *** outcomes were the incidence of fibrinolysis and the risk of all-cause *** were meta-analyzed using the random effects model to derive odds ratios(OR)and 95%confidence *** assessment was carried out using the Newcastle-Ottawa *** Fourteen studies including 50136 STEMI patients(n=15142 in the pandemic arm;n=34994 in the pre-pandemic arm)were *** mean age was 61 years;79%were male,27%had type 2 diabetes,and 47%were *** with the pre-pandemic period,there was a significantly increased overall incidence of fibrinolysis during the pandemic period[OR:1.80(1.18 to 2.75);I2=78%;P=0.00;GRADE:Very low].The incidence of fibrinolysis was not associated with the risk of all-cause mortality in any *** countries with a low-and middle-income status reported a higher incidence of fibrinolysis[OR:5.16(2.18 to 12.22);I2=81%;P=0.00;GRADE:Very lo