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Drug-eluting stents produced lower adverse events risk vs. bare metal stents
Wiisanen ME. J Am Coll Cardiol Intv. 2010;3:1262-1273.
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Risk of complications, including rates of mortality, major adverse cardiac events and target lesion revascularization, were lower in patients treated with drug-eluting stents compared with bare metal stents for saphenous vein graft intervention, according to a meta-analysis published in the Journal of the College of Cardiology: Cardiovascular Interventions.
In the analysis, 19 cohort studies and four randomized controlled trials that compared bare metal stents with drug-eluting stents in saphenous vein graft interventions were analyzed. The studies were derived from database searches that included terms such as percutaneous coronary intervention, CABG, balloon angioplasty and saphenous vein graft.
Researchers found that drug-eluting stent use lowered the risk for all-cause mortality (OR=0.72; 95% CI, 0.58-0.89), major adverse cardiac events (OR=0.61; CI, 0.47-0.79), target lesion revascularization (OR=0.57; 95% CI, 0.40-0.82) and target vessel revascularization (OR=0.56; 95% CI, 0.40-0.77). They reported a significant absolute risk reduction for drug-eluting stent use in the incidence of target lesion revascularization (number needed to treat [NNT], 14), target vessel revascularization (NNT, 10) and major adverse cardiac events (NNT, 8), but not in the incidence of all-cause mortality, MI or stent thrombosis.
“This systematic review and comprehensive meta-analysis of the available studies demonstrates that drug-eluting stent use is associated with a significant reduction in adverse clinical endpoints. … Reassuringly, this improvement has not come with any compromise in safety,” the researchers wrote, adding that the results are no substitute for well-designed, appropriately powered, randomized trials with long follow-up to evaluate the long-term outcomes of drug-eluting stents in saphenous vein graft interventions.
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