Meta-analysis comparing the effect of drug-eluting versus bare metal stents on risk of acute myocardial infarction during follow-up.
The only clinical benefit of drug-eluting stents (DESs) over bare metal stents (BMSs) is a significant decrease in the need for new revascularization procedures. We evaluated whether DESs also decrease the incidence of myocardial infarction at midterm. We performed a meta-analysis from 25 randomized trials comparing commercially available DESs with BMSs that included 9,791 patients overall. There was no heterogeneity across the trials included (Q test for heterogeneity, p = 0.68). Of the 9,791 patients included in all the trials, 364 developed an acute myocardial infarction during follow-up (6 to 12 months). The risk of myocardial infarction was significantly lower in patients allocated to DESs (3.3% vs 4.2% in those allocated to BMSs, odds ratio 0.79, 95% confidence interval 0.64 to 0.97, p = 0.03). In conclusion, the significant decrease in angiographic restenosis associated with the use of DESs leads not only to a decreased need for subsequent revascularization procedures but also a decreased incidence of myocardial infarction during the first 12 months after stent implantation.
Moreno
Raúl
R
Unit of Interventional Cardiology, University Hospital La Paz, Madrid, Spain. raulmorenog@terra.es
Fernández
Cristina
C
Calvo
Luis
L
Sánchez-Recalde
Angel
A
Galeote
Guillermo
G
Sanchez-Aquino
Rosa
R
Alfonso
Fernando
F
Macaya
Carlos
C
López-Sendón
José L
JL
D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D015607:Stents
D007166:Immunosuppressive Agents