Drug-Eluting Stents for Acute Coronary Syndrome: A Meta-Analysis of Randomized Controlled Trials

Wang, Lishan; Zang, Weidong; Xie, Dongli; Ji, Weidong; Pan, Yaosheng; Li, Zhiqiang; Shen, Jiawei; Shi, Yongyong

doi:10.1371/journal.pone.0072895

Cited by 6 publications

(1 citation statement)

References 28 publications

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“…Similar observations for the population of ACS have been published previously, 18 , 24 suggesting that, for the treatment of STEMI, all (first- and second-generation) DES show similar results, notwithstanding higher late lumen loss, restenosis and thrombosis rates for first-generation DES. It seems that the PCI in ACS is similarly efficient regardless of the type of eluting drug.…”

Section: Discussionsupporting

confidence: 87%

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Kawecki¹,

Morawiec²,

Dola³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundThere are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting.ObjectiveThe aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS).MethodsThis all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year.ResultsFrom the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01).Conclusions In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

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Section: Discussionsupporting

confidence: 87%

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Kawecki¹,

Morawiec²,

Dola³

et al. 2016

Arquivos Brasileiros De Cardiologia

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Initial and late efficacy of everolimus-eluting stents for small and non-small coronary lesions from evaluating delayed late loss study

et al. 2017

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The aim of the present study was to evaluate the long-term outcomes at 2 years in patients in whom everolimus-eluting stents (EESs) were implanted in small and non-small vessels. A small vessel is an important risk factor for restenosis with BMSs, even in the first generation DESs. The 690 patients with 690 lesions implanted with an EES were enrolled and divided into two groups by vessel reference diameter (RD): >2.5 mm for non-small vessels (Non-S-group) and ≤2.5 mm for small vessels (S-group). Two years later, the 365 patients with no restenosis at 8 months who underwent angiography were enrolled into the late catch-up study. At the initial 8-month follow-up, the rates of restenosis and target lesion revascularization (TLR) of both groups were not significantly different (restenosis 3.9 vs 6.5%, p = 0.17; TLR 3.9 vs 6.5%, p = 0.17). At the late 2-year follow-up, there were no significant differences in the late loss (0.36 ± 0.66 vs 0.34 ± 0.50 mm, p = 0.14), net gain (1.50 ± 0.75 vs 1.26 ± 0.60 mm, p = 0.39), late catch-up restenosis rate (5.1 vs 3.4%, p = 0.38), TLR (4.9 vs 2.7%, p = 0.40), and delayed late loss (0.14 ± 0.58 vs 0.15 ± 0.49 mm, p = 0.10) between both groups. There is no correlation between delayed late loss and RD in all patients(r = -0.009) and in AMI patients (r = -0.004). These results demonstrate that the initial and late catch-up restenosis rates of small coronary vessels with EES placement were excellent, the same as for non-small coronary vessels. We suggest that involvement of small coronary arteries may not be a risk factor for restenosis and results of stenting for small coronary arteries with EES placement were excellent.

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Contemporary Drug-Eluting Stent Platforms

Partida

Yeh

2017

Cardiology Clinics

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Drug-Eluting Stents for Acute Coronary Syndrome: A Meta-Analysis of Randomized Controlled Trials

Cited by 6 publications

References 28 publications

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Initial and late efficacy of everolimus-eluting stents for small and non-small coronary lesions from evaluating delayed late loss study

Contemporary Drug-Eluting Stent Platforms

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