Effects of liposomal prostaglandin E1 on periprocedural myocardial injury in patients with unstable angina undergoing an elective percutaneous coronary intervention

Abstract

Intravenous lipo-PGE1 can reduce the incidence of PMI following elective PCI in patients with unstable angina. The benefit of lipo-PGE1 may be associated with the effects of anti-inflammation as well as improvement in coronary microvascular perfusion.

Effects of prostaglandin E1 on reperfusion injury patients

“…The PGE1 group had a reduced incidence of CRIE (RR 0.40 [95%CI 0.43, 0.95]) (Fig. 2) compared with control, as reported in 3 studies, [24,25,27] and there was no evidence for statistical heterogeneity (χ 2  = 2.91, I 2  = 0%, and P heterogeneity  = .878). MACE was reported in 3 studies [24,26,27] and the results suggested that PGE1 reduced the incidence of MACE compared with placebo (0.35 [0.17, 0.70]), with no statistical heterogeneity (χ 2  = 1.24, I 2  = 0%, and P heterogeneity  = .978).…”

“…Of the 6 included studies, 3 involved patients receiving elective PCI, [25–27] 1 involved primary PCI, [28] 1 involved elective mitral valve surgery, [29] and 1 involved elective CABG or valve surgery [30] (Table 1). …”

“…In 2 studies, [29,30] patients were administered PGE1 at a dose of 0.02 to 0.05 μg/kg/min from the beginning of surgery to the end of the study. In 2 other studies, [25,26] patients were administered 20 μg/day PGE1 starting at least 48 hours before PCI and continuing for 5 days or starting 3 days before PCI and continuing for 4 days after PCI, respectively. Moreover, one [28] study described the administration of 20 μg PGE1 immediately after coronary angiography and another [27] administered 0.005 to 0.03 μg/kg/min PGE1, starting at least 2 hours before PCI and continuing for 24 hours.…”

“…In 4 studies, the process of sequence generation was correctly performed [25,26,28,29] (Fig. 4), but in the other studies, the methods were not described in detail.…”

“…One study used an open trial design, 3 adopted single blinding, and the other 2 studies did not describe the blinding method; none of the studies contained sufficient information to judge the risk of performance and detection bias. One study exhibited withdrawal bias, [25] but missing data did not affect the analysis so this study was defined as low risk.…”