Table 3

Effect of adjunctive devices on intermediate health outcomes and harms

Outcome

N trials/N pooled

Relative Risk

(95% CI)

I2

Strength of Evidence*

N trials/

N pooled

Relative Risk

(95% CI)

I2


Intermediate Outcomes


All eligible trials

Limited to good quality trials


Catheter Aspiration

ST-segment resolution

15/15

1.51 (1.32 to 1.73)

64.2%

Moderate

10/10

1.39 (1.21 to 1.61)

60.4%

MBG-3

13/13

1.61 (1.41 to 1.84)

55.4%

Moderate

9/9

1.75 (1.44 to 2.14)

69.2%

TIMI-3

13/13

1.08 (1.04 to 1.12)

11.5%

Moderate

10/10

1.07 (1.04 to 1.11)

0%

Distal embolization

10/10

0.56 (0.39 to 0.79)

43.4%

High

8/8

0.48 (0.34 to 0.66)

33.7%

No reflow

8/8

0.52 (0.35 to 0.76)

15.7%

High

6/6

0.45 (0.27 to 0.75)

22.3%


Mechanical Thrombectomy

ST-segment resolution

5/5

1.16 (0.99 to 1.36)

75.1%

Low

5/5

1.16 (0.99 to 1.36)

75.1%

MBG-3

4/4

1.07 (0.80 to 1.43)

76.5%

Low

4/4

1.07 (0.80 to 1.43)

76.5%

TIMI-3

4/4

0.98 (0.92 to 1.04)

67.5%

Moderate

4/4

0.98 (0.92 to 1.04)

67.5%

Distal embolization

3/3

0.44 (0.17 to 1.12)

41.6%

Moderate

3/3

0.44 (0.17 to 1.12)

41.6%

No reflow

3/3

0.50 (0.17 to 1.48)

41.7%

Insufficient

3/3

0.50 (0.17 to 1.48)

41.7%


Distal Filter Embolic Protection

ST-segment resolution

5/5

1.05 (0.97 to 1.15)

0%

Moderate

4/4

1.05 (0.96 to 1.14)

0%

MBG-3

2/2

0.97 (0.81 to 1.15)

NA

Moderate

2/2

0.97 (0.81 to 1.15)

NA

TIMI-3

5/5

1.00 (0.90 to 1.11)

69.6%

Low

4/4

1.02 (0.90 to 1.15)

70.2%

Distal embolization

1/0

0.63 (0.22 to 1.82)†

NA

Insufficient

1/0

0.63 (0.22 to 1.82)†

NA

No reflow

2/2

0.59 (0.14 to 2.51)

NA

Insufficient

1/0

1.00 (0.18 to 5.55)†

NA


Distal Balloon Embolic Protection

ST-segment resolution

4/4

1.08 (0.91 to 1.29)

41.2%

Moderate

4/4

1.08 (0.91 to 1.29)

41.2%

MBG-3

6/6

1.39 (1.15 to 1.69)

43.5%

High

6/6

1.39 (1.15 to 1.69)

43.5%

TIMI-3

9/8

1.11 (1.03 to 1.19)

60.4%

Low

8/7

1.09 (1.01 to 1.17)

59.7%

Distal embolization

4/4

1.10 (0.67 to 1.81)

5.8%

Moderate

4/4

1.10 (0.67 to 1.81)

5.8%

No reflow

4/4

0.51 (0.19 to 1.33)

0%

Insufficient

4/4

0.51 (0.19 to 1.33)

0%


Proximal Balloon Embolic Protection

ST-segment resolution

1/0

1.11 (0.97 to 1.28)†

NA

Insufficient

1/0

1.11 (0.97 to 1.28)†

NA

MBG-3

1/0

0.98 (0.88 to 1.10)†

NA

Insufficient

1/0

0.98 (0.88 to 1.10)†

NA

TIMI-3

1/0

1.06 (0.98 to 1.15)†

NA

Insufficient

1/0

1.06 (0.98 to 1.16)†

NA

Distal embolization

1/0

0.71 (0.37 to 1.35)†

NA

Insufficient

1/0

0.71 (0.38 to 1.33)†

NA

No reflow

1/0

---‡

---‡

Insufficient

1/0

---‡

---‡


Embolic Protection Devices

ST-segment resolution

10/10

1.06 (1.00 to 1.13)

0%

Low

10/10

1.06 (1.00 to 1.13)

0%

MBG-3

9/9

1.20 (1.02 to 1.40)

68.2%

Moderate

9/9

1.20 (1.02 to 1.40)

68.2%

TIMI-3

15/14

1.06 (1.01 to 1.12)

58.3%

Low

15/14

1.06 (1.01 to 1.12)

55.4%

Distal embolization

6/6

0.91 (0.64 to 1.30)

0.2%

Moderate

6/6

0.91 (0.64 to 1.30)

0.2%

No reflow

6/6

0.53 (0.24 to 1.18)

0%

Insufficient

5/5

0.58 (0.25 to 1.37)

0%


Harms


Catheter Aspiration

Coronary dissection

5/5

0.30 (0.12 to 0.75)

0%

High

5/5

0.30 (0.12 to 0.75)

0%

Coronary perforation

1/0

---‡

---‡

Insufficient

1/0

---‡

---‡


Mechanical Thrombectomy

Coronary dissection

1/0

1.51 (0.57 to 4.01)†

NA

Insufficient

1/0

1.51 (0.57 to 4.01)†

NA

Coronary perforation

2/2

1.04 (0.15 to 7.04)

NA

Insufficient

2/2

1.04 (0.15 to 7.04)

NA


Distal Filter Embolic Protection

Coronary dissection

1/0

---‡

---‡

Insufficient

1/0

---‡

---‡

Coronary perforation

1/0

---‡

---‡

Insufficient

1/0

---‡

---‡


Distal Balloon Embolic Protection

Coronary dissection

1/0

---‡

---‡

Insufficient

1/0

---‡

---‡

Coronary perforation

1/0

5.11 (0.53 to infinity)†

NA

Insufficient

1/0

5.11 (0.53 to infinity) †

NA


Proximal Balloon Embolic Protection

Coronary dissection

0/0

---

---

Insufficient

0/0

---

---

Coronary perforation

0/0

---

---

Insufficient

0/0

---

---


Embolic Protection Devices

Coronary dissection

2/0

---‡

---‡

Insufficient

2/0

---‡

---‡

Coronary perforation

1/0

5.11 (0.53 to infinity)†

NA

Insufficient

1/0

5.11 (0.53 to infinity) †

NA


Abbreviations: MBG = myocardial blush grade; N = number; NA = not applicable; TIMI = thrombolysis in myocardial infarction

* Strength of evidence is rated for the primary base analyses only. Subgroup analyses were not rated with strength of evidence; include limiting the analysis to trials of good methodological quality.

† Result is based on a single trial

‡ Risk could not be calculated because no events occurred

Sobieraj et al. BMC Cardiovascular Disorders 2011 11:74   doi:10.1186/1471-2261-11-74

Open Data