Geng DF, Meng Z and Yan HY contributed equally to this work
Coronary Artery Disease
Bare-metal stent versus drug-eluting stent in large coronary arteries
Meta-Analysis of Randomized Controlled Trials
Version of Record online: 26 FEB 2013
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 7, pages 1087–1094, 1 June 2013
How to Cite
Geng, D.-F., Meng, Z., Yan, H.-Y., Nie, R.-Q., Deng, J. and Wang, J.-F. (2013), Bare-metal stent versus drug-eluting stent in large coronary arteries. Cathet. Cardiovasc. Intervent., 81: 1087–1094. doi: 10.1002/ccd.24599
Conflict of interest: Nothing to report.
- Issue online: 24 MAY 2013
- Version of Record online: 26 FEB 2013
- Accepted manuscript online: 17 AUG 2012 12:24AM EST
- Manuscript Accepted: 9 AUG 2012
- Manuscript Received: 18 JUL 2012
- bare-metal stent;
- drug-eluting stent;
- large coronary arteries;
- target vessel revascularization;
- adverse cardiac events
Uncertainties exist with regard to the efficacy of drug-eluting stent (DES) versus bare-metal stent (BMS) in large coronary arteries.
Objective and Methods
The aim of this study was to investigate the efficacy of BMS versus DES in terms of clinical events in large coronary vessels (≥3.0 mm) by performing a meta-analysis of all relevant randomized controlled trials (RCTs).
Six RCTs with 4,399 patients were included in this study. Overall, there were no significant between-group differences in the risks of the composite of cardiac death and nonfatal myocardial infarction (cardiac death/MI), cardiac death, myocardial infarction, and stent thrombosis, however, DES was associated with significant reduction in the risk of target vessel revascularization (TVR) compared with BMS [0.48 (0.33, 0.70)] with consistent benefits among patients with reference vessel diameter ≥ 3.5 mm, reference vessel diameter ≥ 4.0 mm, stent length ≤ 15 mm, first-generation DES or second-generation DES. In patients with ≥ 3-year follow-up, there were no significant between-group differences in the risk of cardiac death/MI, TVR, cardiac death, myocardial infarction or stent thrombosis.
This meta-analysis suggests that DES is superior to BMS in terms of adverse cardiac events in large coronary arteries at the mid-term follow-up. The long-term efficacy of newer-generation DES versus BMS in larger coronary arteries is still worth further evaluation. © 2012 Wiley Periodicals, Inc.