Drug-Eluting Versus Bare-Metal Stents in Unprotected Left Main Coronary Artery Stenosis

• Published in: JACC. Cardiovascular interventions Vol. 3; no. 6; pp. 602 - 611
• Main Authors: Pandya, Sanjay B., MD, Kim, Young-Hak, MD, Meyers, Sheridan N., MD, Davidson, Charles J., MD, Flaherty, James D., MD, Park, Duk-Woo, MD, Mediratta, Anuj, MD, Pieper, Karen, MS, Reyes, Eric, MS, Bonow, Robert O., MD, Park, Seung-Jung, MD, Beohar, Nirat, MD
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.06.2010
• Subjects: Cardiovascular; coronary; intervention; left main; unprotected; major adverse cardiac events; myocardial infarction; HR; odds ratio; drug-eluting stent(s); TVR; percutaneous coronary intervention; MACE; target vessel revascularization; TLR; MI; bare-metal stent(s); coronary; OR; target lesion revascularization; CI; BMS; left main; left main coronary artery stenosis; coronary artery bypass graft surgery; DES; PCI; hazard ratio; confidence interval; unprotected; intervention; CABG; LMCA
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2010.03.019

Drug-Eluting Versus Bare-Metal Stents in Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis Sanjay B. Pandya, Young-Hak Kim, Sheridan N. Meyers, Charles J. Davidson, James D. Flaherty, Duk-Woo Park, Anuj Mediratta, Karen Pieper, Eric Reyes, Robert O. Bonow, Seung-Jung Park, Nirat Beohar We undertook a meta-analysis to assess outcomes for drug-eluting stents (DES) versus bare-metal stents (BMS) in percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) stenosis. We included 44 studies in our overall analysis (n a 10,342 patients); 9 were included in a subsequent comparative analysis (n a 5,081). The co-primary end points were mortality, myocardial infarction, target vessel/lesion revascularization, and major adverse cardiac events at 6 to 12 months, 2 years, and 3 years. At 3 years, the odds ratios favored DES over BMS for mortality (0.70, p a 0.01), myocardial infarction (0.49, p a 0.03), and target vessel/lesion revascularization (0.46, p b 0.01). Thus, our results suggest that DES, when compared with BMS, are associated favorably for use in PCI for ULMCA.