title: Meta-analysis comparing the effect of drug-eluting versus bare metal stents on risk of acute myocardial infarction during follow-up.
abstract: 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.
authors.affiliation: Unit of Interventional Cardiology, University Hospital La Paz, Madrid, Spain. raulmorenog@terra.es
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández
authors.forename: Luis
authors.initials: L
authors.lastname: Calvo
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez-Recalde
authors.forename: Guillermo
authors.initials: G
authors.lastname: Galeote
authors.forename: Rosa
authors.initials: R
authors.lastname: Sanchez-Aquino
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: José L
authors.initials: JL
authors.lastname: López-Sendón
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents