Meta-analysis of long-term outcomes of drug-eluting stent implantations for chronic total coronary occlusions |
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Authors: | Ma Jian Yang Weiwei Singh Manpreet Peng Tianqing Fang Ningyuan Wei Meng |
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Institution: | a Division of Cardiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;b Division of Geriatrics, Shanghai Ren-Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;c Department of Pathology, University of Western Ontario, London, Ontario, Canada;d Critical Illness Research, Lawson Health Research Institute, Department of Medicine and Department of Pathology, University of Western Ontario, London, Ontario, Canada |
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Abstract: | BackgroundIn the treatment of chronic total occlusions (CTOs), some uncertainty exists regarding the effect of drug-eluting stents (DESs) compared with the effects of bare mental stents (BMSs). We reviewed outcomes of DES vs. BMS implantation for CTO lesions, to evaluate the risk-benefit ratio of DES implantation.MethodsRelevant studies of long-term clinical outcomes or angiographic outcomes of both BMS and DES implantation were examined. The primary endpoint comprised major adverse cardiovascular events (MACEs), including all-cause deaths, myocardial infarctions (MIs), and target lesion revascularizations (TLRs). A fixed-effect model and random-effect model were used to analyze the pooling results.ResultsTen studies were included according to the selection criteria. Eight were nonrandomized controlled trials, and two consisted of a randomized controlled comparison between DES and BMS implantation. No significant difference was evident for in-hospital MACE rates between the two groups (odds ratio OR], 1.07; 95% confidence interval CI], .53 to 2.13), but the long-term MACE rates in the DES group were significantly lower than in the BMS group (OR, .22; 95% CI, .13 to .38; P < .00001). The rates of stent restenosis and reocclusions were also significantly lower in the DES group (OR, .14; 95% CI, .09 to .20; and OR, .23; 95% CI, .12 to .41, respectively).ConclusionImplantation of the DES improves long-term angiographic and clinical outcomes compared with BMS in the treatment of CTO lesions. |
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Keywords: | Drug-eluting stents Bare mental stents Chronic total occlusions Meta-analysis |
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