Abstract | BACKGROUND: OBJECTIVE: To compare the efficacy of SES and PES with the efficacy of bare- metal stents for de novo coronary lesions in patients with stable or unstable angina. METHODS: A meta-analysis of randomized trials from MEDLINE, EMBASE and other electronic databases and conference proceedings was conducted. The efficacy of SES, PES with a polymer carrier (PPOL) and PES without a polymer carrier (PNPOL) was compared using random-effects models. RESULTS: Ten trials comprising 5041 patients were included in the meta-analysis. There was an absolute decrease in target lesion revascularization of 17% (95% CI 14% to 20%), 9% (95% CI 6% to 11%) and 3% (95% CI 0% to 6%) with SES, PPOL and PNPOL, respectively, with significant differences between SES and PPOL and between PPOL and PNPOL (P < 0.01 for both comparisons). However, sensitivity analysis using the OR of target lesion revascularization showed no difference between SES (OR 0.18 [95% CI 0.12 to 0.26]) and PPOL (OR 0.25 [95% CI 0.16 to 0.37]) (P = 0.26). There were no differences in the incidence of death, myocardial infarction or stent thrombosis, although the small number of events limited the power of these analyses. CONCLUSIONS: SES show a greater absolute reduction in target lesion revascularization than do PES, likely due to differences in the bare- metal stents used for comparison in the trials. Head-to-head comparisons are needed to directly address the differential efficacy of SES and PES.
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Authors | Michelle M Kittleson, Dale M Needham, S Joseph Kim, Bipin K Ravindran, Sunil S Solomon, Eliseo Guallar |
Journal | The Canadian journal of cardiology
(Can J Cardiol)
Vol. 21
Issue 7
Pg. 581-7
(May 15 2005)
ISSN: 0828-282X [Print] England |
PMID | 15940356
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
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Topics |
- Age Factors
- Aged
- Angioplasty, Balloon, Coronary
(instrumentation, methods)
- Coronary Angiography
- Coronary Restenosis
(diagnostic imaging, epidemiology)
- Dose-Response Relationship, Drug
- Drug Delivery Systems
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(diagnostic imaging, mortality, therapy)
- Paclitaxel
(administration & dosage)
- Prognosis
- Randomized Controlled Trials as Topic
- Severity of Illness Index
- Sex Factors
- Sirolimus
(administration & dosage)
- Stents
- Survival Analysis
- Treatment Outcome
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