A comparison of drug-eluting stents versus bare metal stents in saphenous vein graft PCI outcomes: a meta-analysis.
نویسندگان
چکیده
AIMS Studies demonstrate that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is associated with reduced revascularization and major adverse cardiac events (MACE) rates compared to bare metal stents (BMS) in native coronary vessels. Optimal PCI treatment of saphenous vein graft (SVG) lesions remains unclear despite SVG procedures representing up to 10% of PCI cases. We therefore performed a meta-analysis to compare outcomes between BMS and DES in SVG PCI. METHODS AND RESULTS A search (2004-2009) of MEDLINE and conference proceedings for all relevant studies comparing mortality and MACE outcomes in DES versus BMS in SVG PCI and meta-analysis of the data was performed. Twenty studies were identified from 2005 to 2009 enrolling a total of 5,296 patients. Meta-analysis revealed a decrease in mortality associated with DES use, odds ratio (OR) 0.68; 95% confidence interval (CI) 0.53-0.88; P = 0.004. Similarly, MACE (OR 0.64; 95% CI 0.51-0.82; P < 0.001), total lesion revascularization (OR 0.60; 95% CI 0.43-0.83; P = 0.002), and total vessel revascularization (OR 0.57; 95% CI 0.41-0.80; P = 0.001) were significantly decreased in the patients in which DES were used compared to BMS. This reduction in mortality and MACE events associated with DES use appears to be limited to registry studies and not randomized controlled studies. CONCLUSIONS Our meta-analysis suggests DES use to be safe in SVG PCI and associated with reduced mortality and MACE rates with reductions in revascularization also observed.
منابع مشابه
Drug-Eluting Stents Versus Bare Metal Stents in Saphenous Vein Graft Intervention.
Percutaneous coronary intervention (PCI) of saphenous vein graft (SVG) is associated with higher adverse event rates, lower procedural success, and inferior longterm patency rates compared with native vessel PCI. The ability to comply with dual antiplatelet therapy, and whether the patient will need an interruption in dual antiplatelet therapy, should be considered when deciding whether to impl...
متن کاملLate outcomes of drug eluting and bare metal stents in saphenous vein graft percutaneous coronary intervention.
AIMS PCI with drug eluting stents (DES) has been shown to reduce restenosis and major adverse cardiac event (MACE) rates compared to bare metal stents (BMS) in native coronary vessels, although outcomes in saphenous vein graft (SVG) lesions are less clear. We retrospectively studied 388 consecutive patients admitted to our centre for SVG PCI to assess mortality and MACE outcomes (defined as com...
متن کاملLetter by Hakeem et al regarding article, "Drug-eluting or bare metal stents for the treatment of saphenous vein graft disease: a Bayesian meta-analysis".
متن کامل
Clinical outcome of 2nd generation drug- eluting stents versus bare-metal stents in percutaneous intervention on vein grafts
2015 Background: Superiority of drug-eluting stents (DES) over bare-metal stents (BMS) for treatment of saphenous vein graft (SVG) lesions is controversial. Methods: This is an observational study comparing the incidence of target vessel revascularization, allcause death, myocardial infarction (MI), stroke and stent thrombosis in patients who underwent SVG percutaneous coronary intervention, us...
متن کاملComparison by meta-analysis of drug-eluting stents and bare metal stents for saphenous vein graft intervention.
This meta-analysis was undertaken to assess the efficacy and safety of drug-eluting stents (DESs) compared to bare metal stents (BMSs) in saphenous vein graft (SVG) interventions. DESs decrease the risk of target vessel revascularization in native coronary arteries compared to BMSs. The ideal treatment strategy in patients with SVG disease is unknown. A search of the published reports was condu...
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ورودعنوان ژورنال:
- Journal of interventional cardiology
دوره 24 2 شماره
صفحات -
تاریخ انتشار 2011