| Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis. | |
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MedLine Citation:
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PMID: 17020889 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To evaluate the effect of drug-eluting vs. bare metal stents for the treatment of coronary artery disease on overall, cardiac, and non-cardiac mortalities. METHODS AND RESULTS: We conducted a systematic literature search to identify all randomized controlled trials comparing sirolimus or paclitaxel-eluting stents with bare metal stents and reporting mortality data after at least 1 year of follow-up. Trial data were reviewed and extracted independently by two investigators in an unblinded standardized manner. Seventeen trials including a total of 8221 patients were analysed. Peto's odds ratios (ORs) for total mortality after 1 (n=8221), 2 (n=4631), 3 (n=4105), and 4 (n=1293) years of follow-up were 0.94 [95% confidence interval (CI) 0.66-1.34], 1.11 (95% CI 0.76-1.61), 1.25 (95% CI 0.91-1.73), and 1.46 (95% CI 0.92-2.31), respectively. Corresponding ORs for non-cardiac mortality were 1.07 (95% CI 0.64-1.80), 1.72 (95% CI 1.01-2.94), 1.45 (95% CI 0.93-2.25), and 1.65 (95% CI 0.89-3.10). There was no difference in OR for cardiac mortality among all trials. In sensitivity analyses, sirolimus- but not paclitaxel-eluting stents were associated with an increase in non-cardiac mortality at 2 and 3 years of follow-up. CONCLUSION: Drug-eluting stents for the treatment of coronary artery disease do not reduce total mortality when compared with bare metal stents. Preliminary evidence suggests that sirolimus- but not paclitaxel-eluting stents may lead to increased non-cardiac mortality. Long-term follow-up and assessment of cause-specific deaths in patients receiving drug-eluting stents is mandatory to determine the long-term safety of these devices. |
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Authors:
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Alain Joel Nordmann; Matthias Briel; Heiner Claudins Bucher |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2006-10-04 |
Journal Detail:
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Title: European heart journal Volume: 27 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-11-23 Completed Date: 2007-04-16 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2784-814 Citation Subset: IM |
Affiliation:
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Basel Institute for Clinical Epidemiology, University Hospital Basel, Hebelstrasse 10, 4031 Basel, Switzerland. nordmanna@uhbs.ch |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Disease / mortality, therapy* Drug Implants Follow-Up Studies Graft Occlusion, Vascular / etiology Humans Immunosuppressive Agents / administration & dosage* Middle Aged Paclitaxel / administration & dosage* Randomized Controlled Trials as Topic Sensitivity and Specificity Sirolimus / administration & dosage* Stents* Tubulin Modulators / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Drug Implants; 0/Immunosuppressive Agents; 0/Tubulin Modulators; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2006 Dec;27(23):2737-9
[PMID:
17107977
]
Eur Heart J. 2006 Dec;27(24):3075-6; author reply 3076 [PMID: 17127710 ] ACP J Club. 2007 May-Jun;146(3):66 [PMID: 17474675 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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