Document Detail


Meta-analysis of clinical trials on use of drug-eluting stents for treatment of acute myocardial infarction.
MedLine Citation:
PMID:  17452148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent trials have shown the effects of drug-eluting stents (DES) in treatment of acute myocardial infarction (AMI), but data on the clinical outcome are still incomplete. METHODS: We performed a meta-analysis of all trials comparing DES and bare-metal stents (BMS) in AMI. RESULTS: We found 7 randomized trials comparing the effects of DES and BMS in AMI, enrolling a total of 2357 patients (1177 with DES and 1180 with BMS) with a follow-up of 8 to 12 months. Incidence of major cardiac events (death, myocardial infarction, or revascularization) was 9.3% in patients treated with DES and 17.6% in patients with BMS, with a relative risk (RR) of 0.53 with 95% CI 0.43 to 0.66. Incidence of death or myocardial infarction was similar in the two groups, occurring in 5.8% of patients with DES and 6.9% of patients treated with BMS, with an RR of 0.84 (95% CI 0.62-1.15). Target lesion revascularization occurred in 4.8% of DES and in 12.0% of BMS patients, with an RR of 0.40 (95% CI 0.30-0.54). Stent thrombosis occurred in 2.3% in DES versus 2.6% in BMS patients, with an RR of 0.87 (95% CI 0.53-1.45). There was no heterogeneity among trials in any of the analyses (I2 = 0% for all). CONCLUSIONS: Drug-eluting stents significantly reduce need for revascularization in patients with AMI, without changes in incidence of death or myocardial infarction. Use of DES is not associated with an increased risk of stent thrombosis at 1-year follow-up.
Authors:
Vincenzo Pasceri; Giuseppe Patti; Giulio Speciale; Christian Pristipino; Giuseppe Richichi; Germano Di Sciascio
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  American heart journal     Volume:  153     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-05-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  749-54     Citation Subset:  AIM; IM    
Affiliation:
Interventional Cardiology Unit, San Filippo Neri Hospital, Rome, Italy. vpasceri@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Drug Delivery Systems / adverse effects*,  instrumentation*
Female
Humans
Immunosuppressive Agents / administration & dosage
Incidence
Male
Middle Aged
Myocardial Infarction / mortality*,  therapy*
Paclitaxel / administration & dosage
Randomized Controlled Trials as Topic / methods
Recurrence
Risk
Sirolimus / administration & dosage
Stents / adverse effects*,  classification
Survival Analysis
Thrombosis / epidemiology,  etiology
Treatment Outcome
Tubulin Modulators / administration & dosage
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Tubulin Modulators; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
Am Heart J. 2007 May;153(5):719-21   [PMID:  17452144 ]
Am Heart J. 2007 Nov;154(5):e37; author reply e39   [PMID:  17967577 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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