Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis
Abstract While percutaneous transluminal coronary angioplasty (PTCA) as a primary modality for treating acute myocardial infarction (MI) has been shown to have important advantages over thrombolysis, a survival benefit has not been demonstrated because of the small size of the individual trials. To...
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crwiley:10.1002/clc.4960180110 2024-06-02T08:07:32+00:00 Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis Vaitkus, Paul T. 1995 http://dx.doi.org/10.1002/clc.4960180110 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fclc.4960180110 https://onlinelibrary.wiley.com/doi/pdf/10.1002/clc.4960180110 en eng Wiley http://onlinelibrary.wiley.com/termsAndConditions#vor Clinical Cardiology volume 18, issue 1, page 35-38 ISSN 0160-9289 1932-8737 journal-article 1995 crwiley https://doi.org/10.1002/clc.4960180110 2024-05-03T11:08:24Z Abstract While percutaneous transluminal coronary angioplasty (PTCA) as a primary modality for treating acute myocardial infarction (MI) has been shown to have important advantages over thrombolysis, a survival benefit has not been demonstrated because of the small size of the individual trials. To increase the statistical power to detect a survival benefit, we performed a meta‐analysis of trials of PTCA and thrombolysis. We pooled the data for all randomized, controlled trials; randomized, controlled trials stratified according to thrombolytic agent [streptokinase vs. tissue plasminogen activator (TPA)]; and all trials. Pooling was performed by calculating the Mantel‐Haenszel odds ratio with the Robins, Greenland, and Breslow estimate of variance. Calculation of the Q statistic was performed to assess heterogeneity. For all four analyses, the odds ratio indicated a significant survival advantage of PTCA over thrombolysis: all randomized controlled trials [0.57,95% confidence index (CI): 0.48,0.68)]; streptokinase trials [0.61,95% CI: 0.43,0.87); TPA trials (0.52,95% CI: 0.36,0.76); all trials (0.51,95% CI: 0.43,0.61). The Q statistic was not significant for any of the analyses. The results of our meta‐analysis support the hypothesis that PTCA is associated with a significant reduction in mortality compared with thrombolysis. Article in Journal/Newspaper Greenland Wiley Online Library Greenland Clinical Cardiology 18 1 35 38 |
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Abstract While percutaneous transluminal coronary angioplasty (PTCA) as a primary modality for treating acute myocardial infarction (MI) has been shown to have important advantages over thrombolysis, a survival benefit has not been demonstrated because of the small size of the individual trials. To increase the statistical power to detect a survival benefit, we performed a meta‐analysis of trials of PTCA and thrombolysis. We pooled the data for all randomized, controlled trials; randomized, controlled trials stratified according to thrombolytic agent [streptokinase vs. tissue plasminogen activator (TPA)]; and all trials. Pooling was performed by calculating the Mantel‐Haenszel odds ratio with the Robins, Greenland, and Breslow estimate of variance. Calculation of the Q statistic was performed to assess heterogeneity. For all four analyses, the odds ratio indicated a significant survival advantage of PTCA over thrombolysis: all randomized controlled trials [0.57,95% confidence index (CI): 0.48,0.68)]; streptokinase trials [0.61,95% CI: 0.43,0.87); TPA trials (0.52,95% CI: 0.36,0.76); all trials (0.51,95% CI: 0.43,0.61). The Q statistic was not significant for any of the analyses. The results of our meta‐analysis support the hypothesis that PTCA is associated with a significant reduction in mortality compared with thrombolysis. |
format |
Article in Journal/Newspaper |
author |
Vaitkus, Paul T. |
spellingShingle |
Vaitkus, Paul T. Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
author_facet |
Vaitkus, Paul T. |
author_sort |
Vaitkus, Paul T. |
title |
Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
title_short |
Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
title_full |
Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
title_fullStr |
Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
title_full_unstemmed |
Percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: A meta‐analysis |
title_sort |
percutaneous transluminal coronary angioplasty versus thrombolysis in acute myocardial infarction: a meta‐analysis |
publisher |
Wiley |
publishDate |
1995 |
url |
http://dx.doi.org/10.1002/clc.4960180110 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fclc.4960180110 https://onlinelibrary.wiley.com/doi/pdf/10.1002/clc.4960180110 |
geographic |
Greenland |
geographic_facet |
Greenland |
genre |
Greenland |
genre_facet |
Greenland |
op_source |
Clinical Cardiology volume 18, issue 1, page 35-38 ISSN 0160-9289 1932-8737 |
op_rights |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
op_doi |
https://doi.org/10.1002/clc.4960180110 |
container_title |
Clinical Cardiology |
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18 |
container_issue |
1 |
container_start_page |
35 |
op_container_end_page |
38 |
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1800752632642404352 |