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<p>This study evaluates the role of ultrasound-mediated thrombolysis (sonothrombolysis) as an adjunct to percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI). A comprehensive literature search was conducted across five databases, identifying randomized controlled trials (RCTs) assessing sonothrombolysis in addition to PCI in STEMI patients. Data analysis employed a random effects model in R, focusing on outcomes like left ventricular ejection fraction (LVEF), end diastolic volume (LVEDV), systolic volume (LVESV), left ventricular global longitudinal strain (LV-GLS), and infarct size, evaluated at multiple time points. Six RCTs evaluated sonothrombolysis combined with PCI (241 patients) versus PCI alone (232 patients). LVEF was significantly higher in the sonothrombolysis group immediately post-PCI (MD: 4.00; 95% CI: 1.62, 6.38; P = 0.001) and at subsequent time points (MD: 4.06–4.39; P &lt; 0.01). LVEDV and LVESV were significantly lower at 48–72&#xa0;h and 6&#xa0;months in the sonothrombolysis group. LV-GLS was consistently higher across all time points. Infarct size was notably smaller in the sonothrombolysis arm across all time points (MD: −&#xa0;5.41, 95%CI: [−&#xa0;8.82, −&#xa0;2.00]; p = 0.0018). Sonothrombolysis significantly improves cardiac outcomes following PCI in STEMI patients, showcasing better LVEF, lower LVEDV and LVESV, and reduced infarct size. Further exploration of its standalone and adjunctive potential with PCI is warranted.</p> Graphical Abstract <p>The Illustration depicts the major findings of our meta-analysis</p> <p></p>

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Sonothrombolysis as an adjunct to primary PCI in STEMI: a systematic review and meta-analysis of randomized trials

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Shree Rath,
  • Ahmad Omar Saleh,
  • Osama Ahmad,
  • Mohamed Saad Sayed,
  • Mirza Ammar Arshad,
  • Hossam Hassan Abdullah

摘要

This study evaluates the role of ultrasound-mediated thrombolysis (sonothrombolysis) as an adjunct to percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI). A comprehensive literature search was conducted across five databases, identifying randomized controlled trials (RCTs) assessing sonothrombolysis in addition to PCI in STEMI patients. Data analysis employed a random effects model in R, focusing on outcomes like left ventricular ejection fraction (LVEF), end diastolic volume (LVEDV), systolic volume (LVESV), left ventricular global longitudinal strain (LV-GLS), and infarct size, evaluated at multiple time points. Six RCTs evaluated sonothrombolysis combined with PCI (241 patients) versus PCI alone (232 patients). LVEF was significantly higher in the sonothrombolysis group immediately post-PCI (MD: 4.00; 95% CI: 1.62, 6.38; P = 0.001) and at subsequent time points (MD: 4.06–4.39; P < 0.01). LVEDV and LVESV were significantly lower at 48–72 h and 6 months in the sonothrombolysis group. LV-GLS was consistently higher across all time points. Infarct size was notably smaller in the sonothrombolysis arm across all time points (MD: − 5.41, 95%CI: [− 8.82, − 2.00]; p = 0.0018). Sonothrombolysis significantly improves cardiac outcomes following PCI in STEMI patients, showcasing better LVEF, lower LVEDV and LVESV, and reduced infarct size. Further exploration of its standalone and adjunctive potential with PCI is warranted.

Graphical Abstract

The Illustration depicts the major findings of our meta-analysis