title: Meta-analysis of long-term outcomes of drug-eluting stent implantations for chronic total coronary occlusions.
abstract: BACKGROUND
  In the treatment of chronic total occlusions (CTOs), some uncertainty exists regarding the effect of drug-eluting stents (DESs) compared with the effects of bare mental stents (BMSs). We reviewed outcomes of DES vs. BMS implantation for CTO lesions, to evaluate the risk-benefit ratio of DES implantation.
  
  
  METHODS
  Relevant studies of long-term clinical outcomes or angiographic outcomes of both BMS and DES implantation were examined. The primary endpoint comprised major adverse cardiovascular events (MACEs), including all-cause deaths, myocardial infarctions (MIs), and target lesion revascularizations (TLRs). A fixed-effect model and random-effect model were used to analyze the pooling results.
  
  
  RESULTS
  Ten studies were included according to the selection criteria. Eight were nonrandomized controlled trials, and two consisted of a randomized controlled comparison between DES and BMS implantation. No significant difference was evident for in-hospital MACE rates between the two groups (odds ratio [OR], 1.07; 95% confidence interval [CI], .53 to 2.13), but the long-term MACE rates in the DES group were significantly lower than in the BMS group (OR, .22; 95% CI, .13 to .38; P < .00001). The rates of stent restenosis and reocclusions were also significantly lower in the DES group (OR, .14; 95% CI, .09 to .20; and OR, .23; 95% CI, .12 to .41, respectively).
  
  
  CONCLUSIONS
  Implantation of the DES improves long-term angiographic and clinical outcomes compared with BMS in the treatment of CTO lesions.
authors.affiliation: Division of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ma
authors.forename: Weiwei
authors.initials: W
authors.lastname: Yang
authors.forename: Manpreet
authors.initials: M
authors.lastname: Singh
authors.forename: Tianqing
authors.initials: T
authors.lastname: Peng
authors.forename: Ningyuan
authors.initials: N
authors.lastname: Fang
authors.forename: Meng
authors.initials: M
authors.lastname: Wei
mesh_terms: D000368:Aged; D002423:Cause of Death; D017023:Coronary Angiography / Q000451:nursing; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000401:mortality / Q000451:nursing*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000451:nursing / Q000517:prevention & control; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000451:nursing / Q000517:prevention & control; D009204:Myocardial Revascularization / Q000451:nursing / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000706:statistics & numerical data; D015996:Survival Rate; D016896:Treatment Outcome