PMID- 23592929
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130418
LR  - 20240413
IS  - 1205-6626 (Print)
IS  - 1918-1515 (Electronic)
IS  - 1205-6626 (Linking)
VI  - 17
IP  - 4
DP  - 2012 Winter
TI  - Drug-eluting stents versus bare metal stents in ST elevation myocardial 
      infarction at a follow-up of three years or longer: A meta-analysis of randomized 
      trials.
PG  - 169-74
AB  - BACKGROUND: Drug-eluting stents (DES) are associated with a decreased frequency 
      of repeat revascularization compared with bare metal stents (BMS) in patients 
      with coronary artery disease; however, uncertainty over their long-term safety, 
      especially in high-risk patients, such as those with ST elevation myocardial 
      infarction (STEMI), persists. OBJECTIVE: To evaluate the safety and efficacy of 
      DES compared with BMS in STEMI patients at a follow-up of three years or longer. 
      METHODS: Two independent investigators systematically searched the Medline, 
      CENTRAL, Embase and CardioSource databases for randomized trials comparing DES 
      with BMS in STEMI, and reporting outcomes at three years or longer. Relevant 
      study characteristics and clinical end points were extracted. Random-effect and 
      fixed-effect models were used to calculate ORs for heterogeneous and homogenous 
      outcomes, respectively. RESULTS: Ten randomized trials met the eligibility 
      criteria, resulting in the inclusion of 4330 patients in the DES group and 2662 
      patients in the BMS group. DES use significantly reduced the odds of target 
      vessel (OR 0.44 [95% CI 0.35 to 0.54]) and target lesion revascularization (OR 
      0.47 [95% CI 0.36 to 0.61]). Furthermore, patients in the DES group experienced 
      major adverse coronary events less frequently than patients in the BMS group, 
      which was driven mainly by the decreased revascularization rate. Although the 
      incidence of stent thrombosis was similar, DES was associated with a higher risk 
      of very late stent thrombosis (OR 1.69 [95% CI 1.11 to 2.57]). There were no 
      differences between the groups with respect to death, cardiac death and 
      myocardial infarction. CONCLUSION: DES continues to be associated with a lower 
      repeat revascularization rate in patients with STEMI, with a small but 
      significantly increased risk of very late stent thrombosis compared with BMS at a 
      follow-up of three years or longer.
FAU - Sethi, Ankur
AU  - Sethi A
AD  - Department of Medicine, Rosalind Franklin University of Medicine and Sciences, 
      North Chicago, Illinois;
FAU - Bahekar, Amol
AU  - Bahekar A
FAU - Bhuriya, Rohit
AU  - Bhuriya R
FAU - Bajaj, Anurag
AU  - Bajaj A
FAU - Kovacs, Daniela
AU  - Kovacs D
FAU - Ahmed, Aziz
AU  - Ahmed A
FAU - Khosla, Sandeep
AU  - Khosla S
LA  - eng
PT  - Journal Article
PL  - Canada
TA  - Exp Clin Cardiol
JT  - Experimental and clinical cardiology
JID - 9715903
PMC - PMC3627268
OTO - NOTNLM
OT  - Bare metal stent
OT  - Drug eluting stent, Primary percutaneous coronary intervention
OT  - ST elevation
OT  - Stent thrombosis
EDAT- 2012/01/01 00:00
MHDA- 2012/01/01 00:01
PMCR- 2012/12/01
CRDT- 2013/04/18 06:00
PHST- 2013/04/18 06:00 [entrez]
PHST- 2012/01/01 00:00 [pubmed]
PHST- 2012/01/01 00:01 [medline]
PHST- 2012/12/01 00:00 [pmc-release]
AID - ecc17169 [pii]
PST - ppublish
SO  - Exp Clin Cardiol. 2012 Winter;17(4):169-74.