Document Detail


Drug-eluting stents versus bare-metal stents in saphenous vein graft interventions: a systematic review and meta-analysis.
MedLine Citation:
PMID:  21232720     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to review the published data and perform a meta-analysis to reach robust conclusions in the comparison between bare-metal stents (BMS) and drug-eluting stents (DES) in saphenous vein graft (SVG) percutaneous coronary interventions (PCIs).
BACKGROUND: Drug-eluting stents are superior to BMS in reducing major adverse cardiac events (MACE) after PCI in native coronary arteries. However, studies comparing BMS with DES in PCI of SVG have had mixed results, probably due to smaller numbers and the nonrandomized nature of most of them.
METHODS: The published reports search identified 4 randomized controlled trials and 19 cohort studies comparing BMS with DES in SVG interventions. Clinical end point data were abstracted and analyzed in aggregate and in subgroup analyses with random-effects model.
RESULTS: Patients receiving DES had a lower risk of mortality (odds ratio [OR]: 0.75; confidence interval [CI]: 0.59 to 0.96), target lesion revascularization (TLR) (OR: 0.57; CI: 0.40 to 0.82), target vessel revascularization (TVR) (OR: 0.56; CI: 0.40 to 0.77), and MACE (OR: 0.61; CI: 0.42 to 0.79). Drug-eluting stent use resulted in a significant absolute risk reduction in TLR (-0.07; CI: -0.11 to -0.03), TVR (-0.10; CI: -0.15 to -0.05), and MACE (-0.12; CI: -0.18 to -0.06). There was no significant difference between the groups in recurrent myocardial infarction (OR: 0.99; CI: 0.65 to 1.51) or stent thrombosis (OR: 0.78; CI: 0.40 to 1.52).
CONCLUSIONS: In this meta-analysis comparing DES with BMS use in PCI of SVG lesions, DES use was associated with improved mortality, MACE, TLR, and TVR. There was no evidence of increased risk of myocardial infarction or stent thrombosis.
Authors:
Matthew E Wiisanen; Ahmed Abdel-Latif; Debabrata Mukherjee; Khaled M Ziada
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-01-14     Completed Date:  2011-05-09     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1262-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / adverse effects,  methods*,  statistics & numerical data
Confidence Intervals
Coronary Artery Disease / drug therapy,  mortality,  therapy*
Coronary Restenosis / drug therapy,  mortality,  therapy
Drug-Eluting Stents / adverse effects,  statistics & numerical data*
Humans
Odds Ratio
Risk Factors
Risk Reduction Behavior
Saphenous Vein / transplantation*
Time Factors
Treatment Outcome
World Health
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2011 May;4(5):590-1; author reply 591-3   [PMID:  21596337 ]
JACC Cardiovasc Interv. 2011 May;4(5):590; author reply 591-3   [PMID:  21596336 ]

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