医学
狼牙棒
心肌梗塞
内科学
心脏病学
临床终点
支架
药物洗脱支架
外科
裸金属支架
冠状动脉疾病
经皮冠状动脉介入治疗
随机对照试验
作者
Ángel Sánchez-Recalde,Santiago Jiménez Valero,Raúl Moreno,L. Barreales,Iñigo Lozano,Guillermo Galeote,Roberto V. Reyes,Luis Calvo,Jose Lopez-Sendon
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2010-05-01
卷期号:6 (1): 149-160
被引量:36
摘要
Controversy exists about the safety and efficacy of drug-eluting stents (DES) in saphenous vein bypass grafts (SVGs). The aim of this study was to perform a meta-analysis of all published studies comparing DES and bare-metal stents (BMS) in patients with SVGs disease.We included 22 studies comparing DES versus BMS in 5,543 patients with SVGs disease. The primary efficacy endpoint was target vessel revascularisation (TVR). The primary safety endpoint was mortality. Other outcomes of interest were cardiac mortality, myocardial infarction, target lesion revascularisation (TLR), stent thrombosis and a combined of major adverse cardiac events (MACE). DES significantly reduced the risk of TVR, OR=0.56 (95% CI, 0.41-0.76, p=0.0003) and TLR, OR=0.58 (95% CI, 0.41-0.81; p=0.001). Total mortality and cardiac mortality were significantly lower in DES versus BMS, OR=0.69 (95% CI, 0.49-0.98, p=0.04) and OR=0.71 (95% CI, 0.51-0.99; p=0.04), respectively. The overall risk of stent thrombosis, and myocardial infarction were not significantly different for patients receiving DES vs. BMS. Total MACE were significantly lower in patients receiving DES, OR=0.55 (95% CI, 0.42-0.71; p<0.00001).This meta-analysis suggests that the use of DES in patients with SVG lesions is associated with a reduction of the need of reintervention and mortality compared with BMS.
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