Does direct stenting with drug-eluting stents improve outcome? A meta-analysis of 10,900 patients.

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Citation: Catheterization & Cardiovascular Interventions. 90(2):213-222, 2017 Aug 01.PMID: 27862877Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon/is [Instrumentation] | *Coronary Artery Disease/th [Therapy] | *Drug-Eluting Stents | *Percutaneous Coronary Intervention/is [Instrumentation] | Aged | Angioplasty, Balloon/ae [Adverse Effects] | Angioplasty, Balloon/mo [Mortality] | Chi-Square Distribution | Coronary Artery Disease/dg [Diagnostic Imaging] | Coronary Artery Disease/mo [Mortality] | Female | Humans | Male | Middle Aged | Odds Ratio | Percutaneous Coronary Intervention/ae [Adverse Effects] | Percutaneous Coronary Intervention/mo [Mortality] | Risk Assessment | Risk Factors | Treatment OutcomeYear: 2017Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-1946
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: BACKGROUND: DS has been associated with improved outcomes in the bare-metal stent era. Although DS with DES implantation has been increasingly adopted in clinical practice, its safety and effectiveness remain controversial.CONCLUSIONS: DS with DES is safe and may be associated with better outcomes in selected patients. � 2016 Wiley Periodicals, Inc.Copyright � 2016 Wiley Periodicals, Inc.METHODS: The search criteria identified 546 studies in the Medline/PubMed, Cochrane, and EMBASE databases from 2001 to July 2014. From these, seven studies totaling 10,900 patients were selected. Summarized estimates [odds ratio (OR) and 95% confidence intervals] were obtained using a random-effects model. The primary outcomes were a composite of major adverse cardiac events (MACE), including all-cause death, myocardial infarction (MI), and repeat revascularization. The secondary outcomes included a composite of death and MI and the rates of target lesion revascularization (TLR).OBJECTIVES: The aim of this study is to summarize the outcomes of patients undergoing direct stenting (DS) with drug-eluting stents (DES) compared to those who underwent balloon predilatation.RESULTS: Overall, 4101 (38%) and 6799 (62%) patients underwent DS with DES and balloon pre-dilatation, respectively. DS with DES reduced the likelihood of MACE (OR: 0.81 [0.71-0.93]). Additionally, DS with DES was associated with reduced rates of death/MI (OR: 0.76 [0.62-0.92]), and TLR (OR: 0.66 [0.44-0.98]).All authors: Baker NC, Escarcega RO, Lhermusier T, Magalhaes MA, Minha S, Pendyala L, Pichard A, Satler LF, Torguson R, Waksman RFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-05-24
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27862877 Available 27862877

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

BACKGROUND: DS has been associated with improved outcomes in the bare-metal stent era. Although DS with DES implantation has been increasingly adopted in clinical practice, its safety and effectiveness remain controversial.

CONCLUSIONS: DS with DES is safe and may be associated with better outcomes in selected patients. � 2016 Wiley Periodicals, Inc.

Copyright � 2016 Wiley Periodicals, Inc.

METHODS: The search criteria identified 546 studies in the Medline/PubMed, Cochrane, and EMBASE databases from 2001 to July 2014. From these, seven studies totaling 10,900 patients were selected. Summarized estimates [odds ratio (OR) and 95% confidence intervals] were obtained using a random-effects model. The primary outcomes were a composite of major adverse cardiac events (MACE), including all-cause death, myocardial infarction (MI), and repeat revascularization. The secondary outcomes included a composite of death and MI and the rates of target lesion revascularization (TLR).

OBJECTIVES: The aim of this study is to summarize the outcomes of patients undergoing direct stenting (DS) with drug-eluting stents (DES) compared to those who underwent balloon predilatation.

RESULTS: Overall, 4101 (38%) and 6799 (62%) patients underwent DS with DES and balloon pre-dilatation, respectively. DS with DES reduced the likelihood of MACE (OR: 0.81 [0.71-0.93]). Additionally, DS with DES was associated with reduced rates of death/MI (OR: 0.76 [0.62-0.92]), and TLR (OR: 0.66 [0.44-0.98]).

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