Article ; Online: Long term outcomes of ultrathin versus standard thickness second-generation drug eluting stents: Meta-analysis of randomized trials.
2021 Volume 99, Issue 3, Page(s) 563–574
Abstract: Objective: Identify the effect of ultrathin drug eluting stents on long term outcomes in coronary artery disease.: Background: Although second-generation drug eluting stents (DES) are superior to first-generation DES, persistence of adverse outcomes ... ...
| Abstract | Objective: Identify the effect of ultrathin drug eluting stents on long term outcomes in coronary artery disease. Background: Although second-generation drug eluting stents (DES) are superior to first-generation DES, persistence of adverse outcomes has led to continued refinement in design. Ultrathin second-generation DES have been shown to improve outcomes at 1-year follow-up. Beyond 1-year their effect remains unknown. Methods: PubMed, Embase and Cochrane Database were searched for randomized controlled trials that compared ultrathin (defined as <70 um) to standard thickness second-generation DES. Studies were chosen according to the PROSPERO protocol (CRD42020185374). Data from randomized controlled trials were pooled using random-effects model (Mantel-Haenszel). The primary outcome was target lesion failure (TLF) at 2 years, a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target vessel revascularization. Secondary outcomes included TLF at 3 and 5 years, the components of TLF and definite or probable stent thrombosis. Differences in outcomes between groups were presented in Forest plots as risk ratios (RR) with corresponding 95% confidence intervals (CIs) for each trial. Results: We identified 18 publications from 10 trials with14,649 patients. At 2-years there was a significant 12% reduction in TLF (RR, 0.88; 95% CI 0.78-0.99; p < 0.05) associated with the use of ultrathin DES. At 3-years, there was a significant 19% reduction in TLF with ultrathin DES (RR, 0.79; 95% CI 0.64-0.98; p < 0.05). Conclusion: In patients undergoing percutaneous coronary intervention, ultrathin DES improve long term clinical outcomes. |
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| MeSH term(s) | Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/etiology ; Coronary Artery Disease/therapy ; Drug-Eluting Stents/adverse effects ; Humans ; Percutaneous Coronary Intervention/adverse effects ; Prosthesis Design ; Randomized Controlled Trials as Topic ; Risk Factors ; Treatment Outcome | |||||
| Language | English | |||||
| Publishing date | 2021-07-08 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Meta-Analysis | |||||
| ZDB-ID | 1459995-8 | |||||
| ISSN | 1522-726X ; 1522-1946 | |||||
| ISSN (online) | 1522-726X | |||||
| ISSN | 1522-1946 | |||||
| DOI | 10.1002/ccd.29866 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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