title: Meta-Analysis of Comparison of Drug-Eluting Stents and Bare-Metal Stents in Patients on Dialysis.
abstract: Coronary artery disease is common in patients with end-stage renal disease who are on hemodialysis. The efficacy and safety of evidence regarding the use of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with dialysis is unclear. We searched MEDLINE, EMBASE, Science Citation Index, CINAHL, and the Cochrane CENTRAL database of controlled clinical trials for controlled trials that compare DES and BMS in dialysis patients up to June 2016. We conducted a meta-analysis across 14 eligible studies (n = 62,250 patients). In general, DES-treated patients demonstrate a lower risk of the clinical adverse events compared with those treated with BMS. Significant reduction in the incidence of death (odds ratio [OR] 0.77, CI 0.64 to 0.92) and major adverse cardiovascular events (OR 0.65, CI 0.57 to 0.74) and target lesion/vessel revascularization (OR 0.83, CI 0.73 to 0.94), and a trend toward lower OR for myocardial infarction (OR 0.95, CI 0.87 to 1.02) were noted in DES-treated patients. In conclusion, the use of DES in patients with dialysis yields significant decrease in the risk of mortality, major adverse cardiovascular events, and target lesion/vessel revascularization. Larger randomized studies are needed to confirm the results of this meta-analysis and establish the appropriate stent choice in this high-risk population.
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Ye
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: xuweiweijuly@163.com.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Xu
mesh_terms: D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008670:Metals; D009203:Myocardial Infarction / Q000453:epidemiology; D009204:Myocardial Revascularization; D006435:Renal Dialysis; D015607:Stents
chemical_list: D008670:Metals