The emerging role of adopting protamine for reducing the risk of bleeding complications during the percutaneous coronary intervention: A meta‐analysis. Issue 12 (9th November 2022)

• Record Type: Journal Article
• Authors: Jiang, Yunshan; Liu, Yuzhi; Jia, Xiaoli; Xin, Wenqiang; Wang, Hongyan
• Is Part Of: Journal of cardiac surgery. Volume 37:Issue 12(2022)
• Page Start: 5341
• Page End: 5350
• Publication Date: 2022-11-09
• Subjects: bleeding complications -- coronary heart disease -- meta‐analysis -- percutaneous coronary intervention -- protamine; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.17139
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background: The safety and the benefits of reducing the risk of bleeding complications via protamine administration during the percutaneous coronary intervention (PCI) remains unclear. This study aimed to systematically assessed the efficacy and safety of using protamine in PCI. Method: Potential academic studies were identified from PubMed, Cochrane Library, EMBASE, and Web of Science. The time range we retrieved from was that from the inception of electronic databases to March 31, 2022. Gray studies were identified from the references of included literature reports. Stata version 12.0 statistical software (StataCorp LP) was used to analyze the pooled data. Results: A total of seven studies were involved in our study. The overall participants of the protamine group were 4983, whereas it was 1953 in the nonprotamine group. This meta‐analysis indicated that protamine was preferable for PCI as its lower value of major bleeding (odds ratio [OR] = 0.489, 95% confidence interval [CI]: 0.362–0.661, p < .001) and minor bleeding (OR = 0.281, 95% CI: 0.123–0.643, p = .003). Additionally, the protamine did not tend to be related a higher incidence of mortality ( p = .143), myocardial infarction ( p = .990), and stent thrombosis ( p = .698). Conclusions: Based on available evidence, use of protamine may reduce the risk of bleeding complications without increasing the risk of mortality, myocardial infarction, and stent thrombosis. Given the relevant possible biases in our study, adequately powered and better‐designed studies with long‐term follow‐up are required to reach a firmer conclusion.