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Meta-Analysis of the Impact of Strut Thickness on Outcomes in Patients With Drug-Eluting Stents in a Coronary Artery.

by Iantorno, Micaela; Lipinski, Michael J; Garcia-Garcia, Hector M; Forrestal, Brian J; Rogers, Toby; Gajanana, Deepakraj; Buchanan, Kyle; Torguson, Rebecca; Weintraub, William S; Waksman, Ron.
Citation: American Journal of Cardiology. 2018 Sep 08.Journal: The American journal of cardiology.Published: ; 2018ISSN: 0002-9149.Full author list: Iantorno M; Lipinski MJ; Garcia-Garcia HM; Forrestal BJ; Rogers T; Gajanana D; Buchanan KD; Torguson R; Weintraub WS; Waksman R.UI/PMID: 30292330.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.amjcard.2018.07.040 (Click here) Abbreviated citation: Am J Cardiol. 2018 Sep 08.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: The aim of this network meta-analysis is to assess the impact of strut thickness on clinical outcomes in patients who underwent percutaneous coronary intervention. We searched Medline/PubMed and performed a Bayesian network meta-analysis to compare outcomes of patients who underwent percutaneous coronary intervention with drug-eluting stents (DES) of different strut thicknesses (ultrathin 60 to 80 mum; thin 81 to 100 mum; intermediate 101 to 120 mum; thick >=120 mum). Studies comparing DES with similar strut thickness, bare metal stents, and fully bioresorbable scaffolds were excluded. Odds ratios with credible intervals (OR [CrIs]) were generated with random-effects models to compare outcomes. Our primary end point was stent thrombosis (ST). We identified 69 RCTs including 80,885 patients (ultrathin group=10,219; thin group=36,575; intermediate group=11,399; thick group=22,692). Mean age was 64 +/- 11 years and 75% were male gender. When compared with thick-strut DES, ultrathin struts had significant less ST and myocardial infarction (OR 0.43 [CrI 0.27 to 0.68]; and OR 0.73 [CrI 0.62 to 0.92], respectively). Sensitivity analysis including only studies with permanent polymer DES gave similar results. Improvement in DES technology with thinner struts is associated with significant reduction in ST and myocardial infarction compared with thicker struts.Abstract: Copyright (c) 2018 Elsevier Ltd. All rights reserved.

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