PMID- 29020300
OWN - NLM
STAT- MEDLINE
DCOM- 20180709
LR  - 20180709
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 38
IP  - 42
DP  - 2017 Nov 7
TI  - Impact of design of coronary stents and length of dual antiplatelet therapies on 
      ischaemic and bleeding events: a network meta-analysis of 64 randomized
      controlled trials and 102 735 patients.
PG  - 3160-3172
LID - 10.1093/eurheartj/ehx437 [doi]
AB  - Aims: The differential impact on ischaemic and bleeding events of the type of
      drug-eluting stent [durable polymer stents [DES] vs. biodegradable polymer stents
      vs. bioresorbable scaffolds (BRS)] and length of dual antiplatelet therapy (DAPT)
      remains to be defined. Methods and results: Randomized controlled trials
      comparing different types of DES and/or DAPT durations were selected. The primary
      endpoint was Major Adverse Cardiovascular Events (MACE) [a composite of death,
      myocardial infarction (MI), and target vessel revascularization]. Definite stent 
      thrombosis (ST) and single components of MACE were secondary endpoints. The arms 
      of interest were: BRS with 12 months of DAPT (12mDAPT), biodegradable polymer
      stent with 12mDAPT, durable polymer stent [everolimus-eluting (EES),
      zotarolimus-eluting (ZES)] with 12mDAPT, EES/ZES with <12 months of DAPT, and
      EES/ZES with >12 months of DAPT (DAPT > 12 m). Sixty-four studies with 150 arms
      and 102 735 patients were included. After a median follow-up of 20 months, MACE
      rates were similar in the different arms of interest. EES/ZES with DAPT > 12 m
      reported a lower incidence of MI than the other groups, while BRS showed a higher
      rate of ST when compared to EES/ZES, irrespective of DAPT length. A higher risk
      of major bleedings was observed for DAPT > 12 m as compared to shorter DAPT.
      Conclusion: Durable and biodegradable polymer stents along with BRS report a
      similar rate of MACE irrespective of DAPT length. Fewer MI are observed with
      EES/ZES with DAPT > 12 m, while a higher rate of ST is reported for BRS when
      compared to EES/ZES, independently from DAPT length. Stent type may partially
      affect the outcome together with DAPT length.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved.
      (c) The Author 2017. For permissions, please email: journals.permissions@oup.com.
FAU - D'Ascenzo, Fabrizio
AU  - D'Ascenzo F
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Iannaccone, Mario
AU  - Iannaccone M
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
AD  - Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di
      Sangue 3, 10154 Turin, Italy.
FAU - Saint-Hilary, Gaelle
AU  - Saint-Hilary G
AD  - Department of Mathematical Sciences "G. L. Lagrange", Politecnico di Torino,
      Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
FAU - Bertaina, Maurizio
AU  - Bertaina M
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Schulz-Schupke, Stefanie
AU  - Schulz-Schupke S
AD  - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat
      Munchen Lazarettstrasse 36, Munich 80636, Germany.
FAU - Wahn Lee, Cheol
AU  - Wahn Lee C
AD  - Department of Cardiology, The Heart Institute, Asan Medical Center, University of
      Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
FAU - Chieffo, Alaide
AU  - Chieffo A
AD  - Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina 
      Milano, 60, 20132 Milan, Italy.
FAU - Helft, Gerard
AU  - Helft G
AD  - Department of Cardiology, Cardiology Institute, Pitie-Salpetriere Hospital, UPMC,
      APHP, 47-83 Boulevard de l'Hopital, 75013 Paris, France.
FAU - Gili, Sebastiano
AU  - Gili S
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
AD  - Department of Cardiology, University Heart Center, University Hospital Zurich,
      Ramistrasse 100, 8091 Zurich, Switzerland.
FAU - Barbero, Umberto
AU  - Barbero U
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Biondi Zoccai, Giuseppe
AU  - Biondi Zoccai G
AD  - Department of Cardiology, La Sapienza, Piazzale Aldo Moro, 5, 00185 Rome, Italy.
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University
      of Rome, Corso Della Repubblica 79, 04100 Latina, Italy.
AD  - Department of AngioCardioNeurology, IRCCS Neuromed, Via Atinense, 18, 86077
      Pozzilli, Italy.
FAU - Moretti, Claudio
AU  - Moretti C
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Ugo, Fabrizio
AU  - Ugo F
AD  - Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di
      Sangue 3, 10154 Turin, Italy.
FAU - D'Amico, Maurizio
AU  - D'Amico M
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Garbo, Roberto
AU  - Garbo R
AD  - Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di
      Sangue 3, 10154 Turin, Italy.
FAU - Stone, Gregg
AU  - Stone G
AD  - Department of Cardiology, Columbia University Medical Center, USA Cardiovascular 
      Research Foundation, 161 Ft. Washington Ave. Herbert Irving Pavilion 6th Floor,
      New York, NY 10032 212.305.7060, USA.
FAU - Rettegno, Sara
AU  - Rettegno S
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Omede, Pierluigi
AU  - Omede P
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Conrotto, Federico
AU  - Conrotto F
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
FAU - Templin, Christian
AU  - Templin C
AD  - Department of Cardiology, University Heart Center, University Hospital Zurich,
      Ramistrasse 100, 8091 Zurich, Switzerland.
FAU - Colombo, Antonio
AU  - Colombo A
AD  - Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina 
      Milano, 60, 20132 Milan, Italy.
FAU - Park, Seung-Jung
AU  - Park SJ
AD  - Department of Cardiology, The Heart Institute, Asan Medical Center, University of
      Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
FAU - Kastrati, Adnan
AU  - Kastrati A
AD  - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat
      Munchen Lazarettstrasse 36, Munich 80636, Germany.
FAU - Hildick-Smith, David
AU  - Hildick-Smith D
AD  - Department of Cardiology, Sussex Cardiac Centre, Barry Building, Eastern Rd,
      Brighton BN2 5BE, UK.
FAU - Gasparini, Mauro
AU  - Gasparini M
AD  - Department of Mathematical Sciences "G. L. Lagrange", Politecnico di Torino,
      Corso Duca degli Abruzzi 24, 10129 Turin, Italy.
FAU - Gaita, Fiorenzo
AU  - Gaita F
AD  - Department of Cardiology, Citta Della Salute e della Scienza Hospital, Corso
      Bramante 88/90, 10126 Turin, Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Absorbable Implants
MH  - Coronary Artery Disease/*therapy
MH  - Drug Therapy, Combination
MH  - *Drug-Eluting Stents
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Myocardial Ischemia/therapy
MH  - Network Meta-Analysis
MH  - Percutaneous Coronary Intervention
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - BRS DES EES ZES
OT  - DAPT
OT  - DAPT duration
OT  - Length of dual antiplatelet therapy
OT  - Network meta-analysis
OT  - Percutaneous coronary intervention
OT  - Stents
EDAT- 2017/10/12 06:00
MHDA- 2018/07/10 06:00
CRDT- 2017/10/12 06:00
PHST- 2016/11/15 00:00 [received]
PHST- 2017/07/13 00:00 [accepted]
PHST- 2017/10/12 06:00 [pubmed]
PHST- 2018/07/10 06:00 [medline]
PHST- 2017/10/12 06:00 [entrez]
AID - 4080728 [pii]
AID - 10.1093/eurheartj/ehx437 [doi]
PST - ppublish
SO  - Eur Heart J. 2017 Nov 7;38(42):3160-3172. doi: 10.1093/eurheartj/ehx437.