title: Second-generation versus first-generation drug-eluting stents in saphenous vein graftdisease: A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Second-generation drug-eluting stents (DESs) have become increasingly popular devices for patients with saphenous vein graft (SVG) disease. Second-generation DESs were designed to have more safety and efficacy than first-generation DES, but clinical outcomes in SVG disease remain conflicting.
  
  
  RESULTS
  Randomized controlled trials (RCTs) were identified when comparing second- versus first-generation DESs in SVG disease. The main endpoint was all-cause death. The time of follow-up was at least 30days. The secondary endpoints were major adverse cardiovascular events (MACEs), target vessel revascularization (TVR), target lesion revascularization (TLR), myocardial infarction (MI), and stent thrombosis. These endpoints were assessed at 30days, 12months and 24months. Four RCTs with 1077 SVG patients undergoing the implantation of DES were collected in the current meta-analysis. As a result, second-generation DES-treated patients had the significantly lower MACE rates at 12months (P=0.03; OR: 0.69, 95% CI: 0.49,0.97). No differences in two groups were seen in all-cause death, MI, TVR, stent thrombosis and TLR.
  
  
  CONCLUSIONS
  Our limited evidence indicated that, second-generation DES in SVG patients, compared with first-generation DES, offered similar levels of safety, but were more effective than the former one.
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Hong-Tao
authors.initials: HT
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Qingdao Medical College, Qingdao University, 264000 Yantai, Shandong Province, PR China.
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Chu
authors.affiliation: Department of Hypertension Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, 100029 Beijing, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Cardiology, Jiangxi Provincial People's Hospital, 330006 Nanchang, Jiangxi Province, PR China.
authors.forename: Xin-Yong
authors.initials: XY
authors.lastname: Cai
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China; Department of Cardiology, the Affiliated Hospital of Qingdao University, 266003 Qingdao, Shandong Province, PR China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Rizhao City Hospital of Traditional Chinese Medicine, 276800 Rizhao, Shandong Province, PR China.
authors.forename: Zhao-Gang
authors.initials: ZG
authors.lastname: Ding
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Lei-Lei
authors.initials: LL
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Jian-Bing
authors.initials: JB
authors.lastname: Zhu
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Zhe-Yong
authors.initials: ZY
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China.
authors.forename: Qi-Bing
authors.initials: QB
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 200032 Shanghai, PR China. Electronic address: jbge@zs-hospital.sh.cn.
authors.forename: Jun-Bo
authors.initials: JB
authors.lastname: Ge
authors.affiliation: Department of Hypertension Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, 100029 Beijing, PR China. Electronic address: anzhenwensj@sina.com.
authors.forename: Shao-Jun
authors.initials: SJ
authors.lastname: Wen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D009204:Myocardial Revascularization / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012501:Saphenous Vein / Q000637:transplantation*; D016019:Survival Analysis; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
keywords: First-generation drug-eluting stent; Meta-analysis; Saphenous vein grafts; Second-generation drug-eluting stent