Abstract 20132: Drug-eluting Stents versus Bare Metal Stents for Non-ST-segment Elevation Myocardial Infarction (NSTE-ACS): A Meta-analysis of 44,123 Patients
Introduction: The efficacy of drug-eluting stents (DES) compared to bare-metal stents (BMS) in patients with Non-ST-segment Elevation Myocardial Infarction (NSTE-ACS) is unclear.
Methods: Pubmed, Scopus and Clinical trials.gov databases were searched to identify all studies that compared DES with BMS in patients with NSTE-ACS. We evaluated the following efficacy and safety outcomes: all-cause mortality, cardiovascular mortality, myocardial infarction, stent thrombosis, target vessel revascularization and major advance cardiovascular events (MACE) at the longest reported follow-up times. Random-effects model was used to pool study results.
Results: A total of 11 cohort studies with 44,123 patients were included. The mean follow-up duration was 2.3 years. Of note, all studies compared first generation DES with BMS. Patients receiving DES had significantly lower all-cause mortality (Relative risk [RR]: 0.74, 95% confidence interval [CI]: 0.64 - 0.86, p<0.001), cardiovascular mortality (RR: 0.73, 95% CI: 0.54 - 0.99, p=0.02), MACE (RR: 0.71, 95% CI: 0.54 - 0.94, p=0.02) and target vessel revascularization (RR: 0.64, 95% CI: 0.49 - 0.82, p=0.001). There was no significant difference in the incidence of myocardial infarction (RR: 0.88, 95% CI: 0.67 - 1.15, p=0.34) and stent thrombosis (RR: 0.98, 95% CI: 0.71 - 1.35, p=0.89).
Conclusions: Compared to BMS, DES is associated with improved outcomes with non-significant differences in myocardial infarction and stent thrombosis. Further randomized controlled trials including studies with newer DES, are required to evaluate the efficacy and safety of DES in patients with NSTE-ACS.
Author Disclosures: C. Bavishi: None. A.R. Khan: None. V. Trivedi: None. C. Gongora: None. S. Ather: None.
- © 2015 by American Heart Association, Inc.