title: Drug-eluting stents versus bare-metal stents in saphenous vein graft interventions: a systematic review and meta-analysis.
abstract: OBJECTIVE
  We sought to review the published data and perform a meta-analysis to reach robust conclusions in the comparison between bare-metal stents (BMS) and drug-eluting stents (DES) in saphenous vein graft (SVG) percutaneous coronary interventions (PCIs).
  
  
  BACKGROUND
  Drug-eluting stents are superior to BMS in reducing major adverse cardiac events (MACE) after PCI in native coronary arteries. However, studies comparing BMS with DES in PCI of SVG have had mixed results, probably due to smaller numbers and the nonrandomized nature of most of them.
  
  
  METHODS
  The published reports search identified 4 randomized controlled trials and 19 cohort studies comparing BMS with DES in SVG interventions. Clinical end point data were abstracted and analyzed in aggregate and in subgroup analyses with random-effects model.
  
  
  RESULTS
  Patients receiving DES had a lower risk of mortality (odds ratio [OR]: 0.75; confidence interval [CI]: 0.59 to 0.96), target lesion revascularization (TLR) (OR: 0.57; CI: 0.40 to 0.82), target vessel revascularization (TVR) (OR: 0.56; CI: 0.40 to 0.77), and MACE (OR: 0.61; CI: 0.42 to 0.79). Drug-eluting stent use resulted in a significant absolute risk reduction in TLR (-0.07; CI: -0.11 to -0.03), TVR (-0.10; CI: -0.15 to -0.05), and MACE (-0.12; CI: -0.18 to -0.06). There was no significant difference between the groups in recurrent myocardial infarction (OR: 0.99; CI: 0.65 to 1.51) or stent thrombosis (OR: 0.78; CI: 0.40 to 1.52).
  
  
  CONCLUSIONS
  In this meta-analysis comparing DES with BMS use in PCI of SVG lesions, DES use was associated with improved mortality, MACE, TLR, and TVR. There was no evidence of increased risk of myocardial infarction or stent thrombosis.
authors.affiliation: Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, 900 South Limestone Street, Lexington, KY 40536-0200, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Wiisanen
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Latif
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Ziada
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D014943:Global Health; D006801:Humans; D016017:Odds Ratio; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome