Long-term outcomes of drug-eluting stents versus bare metal stents in saphenous vein graft interventions. Evidence from a meta-analysis of randomized controlled trials |
| |
Institution: | 1. University of Southern California, Los Angeles, CA, United States of America;2. University of Arkansas for Medical Sciences, Little Rock, AR, United States of America;1. Kingston General Hospital, Division of Cardiology, Kingston, Ontario, Canada;2. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Division of Cardiology, Quebec City, Quebec, Canada;1. Cardiology, University Hospital Bern, 3010 Bern, Switzerland;2. Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland;1. Belfast Health and Social Care Trust, Belfast, United Kingdom;2. St George''s University NHS Trust, London, United Kingdom |
| |
Abstract: | BackgroundThe optimal stent for use in saphenous vein graft (SVG) intervention is still debatable. Multiple randomized trials have compared drug-eluting stents (DES) to bare metal stents (BMS) in SVG interventions with conflicting results.MethodsAuthors searched the online databases for randomized controlled trials (RCTs) comparing DES to BMS in SVG percutaneous coronary interventions (PCI). We performed a meta-analysis using a random effects model to calculate the odds ratio for outcomes of interest.ResultsAuthors studied six RCTs that included 1592 patients undergoing PCI of SVG. The mean follow up was 42 months. Patients mean age was the same in both groups: 70.3 years in the DES group (approximately 93.3% male) and 70.3 years in the BMS group (approximately 93.8% male). Vein graft age was 13.4 years in the DES PCI arm vs. 13.4 years in the BMS PCI arm. Four of the six trials reported data on embolic protection device use: 67% (303/452) in the DES arm vs. 67.9% (309/455) in the BMS arm. The primary outcome of long-term all-cause mortality was not different between DES vs. BMS (15.2% vs. 14.1%, OR 1.12, 95% CI 0.67–1.88; P = 0.66). Secondary outcomes were also similar between DES and BMS: major adverse cardiovascular events (31.6% vs. 33.1%, OR 0.79, 95% CI 0.45–1.38; P = 0.41); cardiac death (9% vs. 8.6%, OR 1.12, 95% CI 0.55–2.30; P = 0.75); myocardial infarction (8% vs. 9.5%, OR 0.84, 95% CI 0.47–1.51; P = 0.57); target lesion revascularization (16.4% vs. 14.4%, OR 0.98, 95% CI 0.50–1.92; P = 0.95); and target vessel revascularization (19% vs. 19.4%, OR 0.75, 95% CI 0.41–1.34; P = 0.33).ConclusionAt a mean follow-up of 42 months, no difference was observed in clinical outcomes between DES and BMS in SVG interventions. |
| |
Keywords: | |
本文献已被 ScienceDirect 等数据库收录! |
|