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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Meta-analysis of corticosteroid treatment in acute myocardial infarction

Gregory R Giugliano1, Robert P Giugliano, C Michael Gibson

  • 1Division of Clinical Biometrics, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA. ggiugliano@partners.org

The American Journal of Cardiology
|April 26, 2003
PubMed

Insights

Corticosteroids may reduce mortality in acute myocardial infarction (AMI) patients. This review found no evidence of harm, suggesting a potential mortality benefit for this anti-inflammatory treatment in AMI.

Area of Science:

  • Cardiology
  • Pharmacology
  • Inflammation Research

Background:

  • Acute and chronic inflammation are key in atherosclerosis.
  • Corticosteroids are standard anti-inflammatories but raise concerns about impaired healing in myocardial infarction (MI).

Purpose of the Study:

  • To evaluate the safety and efficacy of corticosteroids in treating acute myocardial infarction (AMI).

Main Methods:

  • A meta-analysis of controlled trials was conducted using MEDLINE and PreMEDLINE databases (1966-2002).
  • Included 16 studies with 3,793 patients; meta-analysis focused on 11 trials (2,646 patients) for mortality.
  • Sensitivity analyses and publication bias tests were performed.

Main Results:

  • Most studies were small with conflicting surrogate outcomes (e.g., infarct size).
  • No clear link to myocardial rupture was found.
  • Meta-analysis showed a 26% decrease in mortality with corticosteroids (OR 0.74, P=0.015).

Conclusions:

  • Corticosteroid use in acute myocardial infarction demonstrated no observed harm.
  • A potential mortality benefit exists, warranting further investigation.

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