Regular paperMeta-analysis of corticosteroid treatment in acute myocardial infarction
Section snippets
Literature search
The MEDLINE and PreMEDLINE databases were searched for articles containing the Medical Subject Heading index terms steroids, MI, heart rupture, heart aneurysm, and methylprednisolone from 1966 through May 2002. Medical Subject Heading terms were combined using simple Boolean connectors. Two reviewers extracted additional data sources from the bibliographies of articles that were identified. Studies were then chosen if they were performed in humans, written in English and had both treatment
Results
Of 186 articles identified, 16 English-language studies (3,793 patients) met our inclusion criteria, including 1 case-series, 2 retrospective case-control, and 13 prospective studies, of which 8 were randomized (Table 1). Five studies1, 2, 3, 4, 6 did not provide mortality data and were excluded from the meta-analysis.
Discussion
Methods to minimize damage in AMI have evolved from simply improving the supply–demand oxygen ratio20 in the infarcting myocardium (using supplemental oxygen and β blockers) to optimizing epicardial and microvascular reperfusion using pharmacologic and/or mechanical reperfusion strategies.21 Currently, there are investigations using experimental combinations of interventional and pharmacologic therapies that include total body cooling, therapies to limit reperfusion injury, aggressive
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