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Catheter Cardiovasc Interv. 2013 Jun 1;81(7):1087-94. doi: 10.1002/ccd.24599. Epub 2013 Feb 26.

Bare-metal stent versus drug-eluting stent in large coronary arteries: meta-analysis of randomized controlled trials.

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  • 1Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120, China.

Abstract

BACKGROUND:

Uncertainties exist with regard to the efficacy of drug-eluting stent (DES) versus bare-metal stent (BMS) in large coronary arteries.

OBJECTIVE AND METHODS:

The aim of this study was to investigate the efficacy of BMS versus DES in terms of clinical events in large coronary vessels (≥3.0 mm) by performing a meta-analysis of all relevant randomized controlled trials (RCTs).

RESULTS:

Six RCTs with 4,399 patients were included in this study. Overall, there were no significant between-group differences in the risks of the composite of cardiac death and nonfatal myocardial infarction (cardiac death/MI), cardiac death, myocardial infarction, and stent thrombosis, however, DES was associated with significant reduction in the risk of target vessel revascularization (TVR) compared with BMS [0.48 (0.33, 0.70)] with consistent benefits among patients with reference vessel diameter ≥ 3.5 mm, reference vessel diameter ≥ 4.0 mm, stent length ≤ 15 mm, first-generation DES or second-generation DES. In patients with ≥ 3-year follow-up, there were no significant between-group differences in the risk of cardiac death/MI, TVR, cardiac death, myocardial infarction or stent thrombosis.

CONCLUSIONS:

This meta-analysis suggests that DES is superior to BMS in terms of adverse cardiac events in large coronary arteries at the mid-term follow-up. The long-term efficacy of newer-generation DES versus BMS in larger coronary arteries is still worth further evaluation.

Copyright © 2012 Wiley Periodicals, Inc.

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PMID:
22899538
[PubMed - indexed for MEDLINE]
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