Long-term outcomes of drug-eluting stents versus bare metal stents in saphenous vein graft interventions. Evidence from a meta-analysis of randomized controlled trials.
Cardiovasc Revasc Med
; 19(8): 951-955, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30078629
ABSTRACT
BACKGROUND:
The optimal stent for use in saphenous vein graft (SVG) intervention is still debatable. Multiple randomized trials have compared drug-eluting stents (DES) to bare metal stents (BMS) in SVG interventions with conflicting results.METHODS:
Authors searched the online databases for randomized controlled trials (RCTs) comparing DES to BMS in SVG percutaneous coronary interventions (PCI). We performed a meta-analysis using a random effects model to calculate the odds ratio for outcomes of interest.RESULTS:
Authors studied six RCTs that included 1592 patients undergoing PCI of SVG. The mean follow up was 42â¯months. Patients mean age was the same in both groups 70.3â¯years in the DES group (approximately 93.3% male) and 70.3â¯years in the BMS group (approximately 93.8% male). Vein graft age was 13.4â¯years in the DES PCI arm vs. 13.4â¯years in the BMS PCI arm. Four of the six trials reported data on embolic protection device use 67% (303/452) in the DES arm vs. 67.9% (309/455) in the BMS arm. The primary outcome of long-term all-cause mortality was not different between DES vs. BMS (15.2% vs. 14.1%, OR 1.12, 95% CI 0.67-1.88; Pâ¯=â¯0.66). Secondary outcomes were also similar between DES and BMS major adverse cardiovascular events (31.6% vs. 33.1%, OR 0.79, 95% CI 0.45-1.38; Pâ¯=â¯0.41); cardiac death (9% vs. 8.6%, OR 1.12, 95% CI 0.55-2.30; Pâ¯=â¯0.75); myocardial infarction (8% vs. 9.5%, OR 0.84, 95% CI 0.47-1.51; Pâ¯=â¯0.57); target lesion revascularization (16.4% vs. 14.4%, OR 0.98, 95% CI 0.50-1.92; Pâ¯=â¯0.95); and target vessel revascularization (19% vs. 19.4%, OR 0.75, 95% CI 0.41-1.34; Pâ¯=â¯0.33).CONCLUSION:
At a mean follow-up of 42â¯months, no difference was observed in clinical outcomes between DES and BMS in SVG interventions.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Veia Safena
/
Doença da Artéria Coronariana
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Ensaios Clínicos Controlados Aleatórios como Assunto
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Stents Farmacológicos
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Intervenção Coronária Percutânea
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Cardiovasc Revasc Med
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article