TY - JOUR
T1 - Drug-eluting Stents Versus Bare-metal Stents for Saphenous Vein Graft Interventions
T2 - A Systematic Review and Meta-analysis of Studies With Longer Follow-up
AU - Garg, Aakash
AU - Rout, Amit
AU - Tayal, Raj
AU - Sharma, Abhishek
AU - Agrawal, Sahil
AU - Kostis, John B.
AU - Cohen, Marc
AU - Sharma, Samin
AU - Wasty, Najam
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2021/1
Y1 - 2021/1
N2 - Randomized controlled trials comparing drug eluting stents (DES) with bare-metal stents (BMS) for saphenous vein graft (SVG) interventions have shown conflicting results. We conducted this meta-analysis to evaluate the cumulative evidence for long-term efficacy and safety of DES vs BMS in SVG lesions. A systematic search was conducted of Randomized controlled trials comparing DES vs BMS in patients undergoing percutaneous interventions for SVG lesions. End-points of interest were all-cause death, cardiac death, myocardial infarction, target lesion revascularization and target vessel revascularization at longest available follow-up. Random effects meta-analysis was conducted to estimate risk ratio with 95% confidence intervals for individual end-points. Seven studies with 1639 patients were included in the final analysis. Mean follow-up period was 32 months. Compared with BMS, DES was associated with similar risks of all-cause death (risk ratio 1.06; 95% confidence intervals 0.76-1.48) and cardiac death (0.95; 0.59-1.54). Similarly, there were no differences between DES and BMS in terms of myocardial infarction (0.81; 0.50-1.29), target vessel revascularization (0.73; 0.48-1.110 or target lesion revascularization (1.05; 0.76-1.43). Current analysis suggests no strong evidence for routine DES use in patients undergoing SVG intervention. Future studies should evaluate if SVG lesion characteristics could influence these results.
AB - Randomized controlled trials comparing drug eluting stents (DES) with bare-metal stents (BMS) for saphenous vein graft (SVG) interventions have shown conflicting results. We conducted this meta-analysis to evaluate the cumulative evidence for long-term efficacy and safety of DES vs BMS in SVG lesions. A systematic search was conducted of Randomized controlled trials comparing DES vs BMS in patients undergoing percutaneous interventions for SVG lesions. End-points of interest were all-cause death, cardiac death, myocardial infarction, target lesion revascularization and target vessel revascularization at longest available follow-up. Random effects meta-analysis was conducted to estimate risk ratio with 95% confidence intervals for individual end-points. Seven studies with 1639 patients were included in the final analysis. Mean follow-up period was 32 months. Compared with BMS, DES was associated with similar risks of all-cause death (risk ratio 1.06; 95% confidence intervals 0.76-1.48) and cardiac death (0.95; 0.59-1.54). Similarly, there were no differences between DES and BMS in terms of myocardial infarction (0.81; 0.50-1.29), target vessel revascularization (0.73; 0.48-1.110 or target lesion revascularization (1.05; 0.76-1.43). Current analysis suggests no strong evidence for routine DES use in patients undergoing SVG intervention. Future studies should evaluate if SVG lesion characteristics could influence these results.
UR - http://www.scopus.com/inward/record.url?scp=85061636148&partnerID=8YFLogxK
U2 - 10.1016/j.cpcardiol.2018.12.002
DO - 10.1016/j.cpcardiol.2018.12.002
M3 - Review article
C2 - 30792045
AN - SCOPUS:85061636148
SN - 0146-2806
VL - 46
JO - Current Problems in Cardiology
JF - Current Problems in Cardiology
IS - 1
M1 - 100405
ER -