Relation of myocardial bridge to myocardial infarction: a meta-analysis.

Lifeng Hong; Jun Liu; Songhui Luo; Jianjun LI

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Relation of myocardial bridge to myocardial infarction: a meta-analysis.

Author: Lifeng HONG ^{1
,

2} ; Jun LIU ³ ; Songhui LUO ⁴ ; Jianjun LI ⁵
Author Information

1. Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
2. Divison of Cardiology, Fifth Hospital of Wuhan & Affiliated Guangci Hospital of Wuhan University, Wuhan, Hubei 430050, China.
3. Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
4. Divison of Cardiology, Fifth Hospital of Wuhan & Affiliated Guangci Hospital of Wuhan University, Wuhan, Hubei 430050, China.
5. Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. Email: lijianjun938@yahoo.com.
Publication Type:Journal Article
MeSH: Humans; Myocardial Bridging; complications; epidemiology; Myocardial Infarction; epidemiology; etiology
From: Chinese Medical Journal 2014;127(5):945-950
CountryChina
Language:English
Abstract:
BACKGROUNDSmall case series have suggested an association of coronary myocardial bridge (MB) with myocardial infarction (MI). However, the relationship between MB and major adverse cardiac events (MACE) remains largely unknown. The aim of this study was to assess the relationship between MB and MACE involving MI.
METHODSWe performed a systematic search of MEDLINE, PreMEDLINE, and all EMB Reviews as well as a reference list of relevant articles according to the SPICO (Study design, Patient, Intervention, Control-intervention, and Outcome) criteria using the following keywords: myocardial bridging, myocardial bridge, intramural coronary artery, mural coronary artery, tunneled coronary artery, coronary artery overbridging, etc. Bibliographies of the retrieved publications were additionally hand searched. Studies were included for the meta-analysis if they satisfied the following criteria: (1) they evaluate the association of MB with cardiovascular endpoint event; (2) they included individuals with MB and those without MB; 3) they excluded individuals with obstructive coronary artery disease (CAD). Studies were reviewed by a predetermined protocol including quality assessment. Dates were pooled using a random effect model.
RESULTSSeven observational studies that followed 5 486 patients eligible for the enrolled criteria were included from 7 136 initially identified articles. The prevalence of MB was 24.8% (1 363/5 486). During 0.5-7.0 years of follow-up of this cohort of population, crude outcome rates were 8.0% in the MB group and 7.7% in the non-MB group. The odds ratio of overall MACE and MI were 1.34 (95% confidence interval (CI): 0.57-3.17, P = 0.51, n = 7 studies) and 2.75 (95% CI: 1.08-7.02, P < 0.03, n = 5 studies) respectively for subjects of MB compared to non-MB.
CONCLUSIONRelationship between MB and MI appears to be a real one, although the study did not reveal a connection of MB to MACE, suggesting whether the necessity of antiplatelet therapy needs to be further studied in a larger cohort of patients with MB prospectively.