Comparison by Meta-Analysis of Drug-Eluting Stents and Bare Metal Stents for Saphenous Vein Graft Intervention

• Published in: The American journal of cardiology Vol. 105; no. 8; pp. 1076 - 1082
• Main Authors: Lee, Michael S., MD, Yang, Tae, MD, Kandzari, David E., MD, Tobis, Jonathan M., MD, Liao, Hsini, PhD, Mahmud, Ehtisham, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.04.2010; Elsevier; Elsevier Limited
• Subjects: Antineoplastic Agents, Phytogenic - pharmacology; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Clinical trials; Comparative analysis; Coronary Restenosis - epidemiology; Coronary Restenosis - prevention & control; Coronary Stenosis - surgery; Coronary vessels; Drug-Eluting Stents; Heart attacks; Humans; Immunosuppressive Agents - pharmacology; Incidence; Medical sciences; Meta-analysis; Myocardial Infarction - epidemiology; Myocardial Infarction - prevention & control; Myocardial Revascularization - methods; Paclitaxel - pharmacology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Saphenous Vein - transplantation; Sirolimus - pharmacology; Stents; Treatment Outcome; United States - epidemiology; United States; Endoprosthesis; Saphenous vein; Analysis; Surgery; Instrumentation therapy; Graft; Circulatory system; Metal; Cardiology; Drug eluting stent; Comparative study
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.12.006

This meta-analysis was undertaken to assess the efficacy and safety of drug-eluting stents (DESs) compared to bare metal stents (BMSs) in saphenous vein graft (SVG) interventions. DESs decrease the risk of target vessel revascularization in native coronary arteries compared to BMSs. The ideal treatment strategy in patients with SVG disease is unknown. A search of the published reports was conducted to identify studies that compared DESs and BMSs in SVG intervention with a minimum follow-up of 6 months. A total of 19 studies (2 randomized trials and 17 registries), including 3,420 patients who had undergone SVG intervention (DESs, n = 1,489 and BMS, n = 1,931), met the selection criteria. The mean length of follow-up was 20 ± 12 months. Using the fixed effect model, target vessel revascularization was less frequently performed in patients who had undergone SVG intervention with a DES than with a BMS (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.49 to 0.72). The incidence of myocardial infarction was lower in patients with a DES than in those with a BMS (OR 0.69, 95% CI 0.49 to 0.99). No differences were found in the risk of death (OR 0.78, 95% CI 0.59 to 1.02) or stent thrombosis (OR 0.41, 95% CI 0.15 to 1.11) between the 2 groups. In conclusion, these findings support the use of DESs in SVG lesions.