Abstract 12170: Long-term Clinical Outcomes of Drug-eluting Stent vs Bare Metal Stent for Unprotected Left Main Disease: A Meta-analysis
Background: The long-term benefits of drug-eluting stents (DES) compared to bare metal stents (BMS) for the unprotected left main (ULM) disease are unclear. We aimed at investigating the long-term clinical outcomes in patients treated with DES vs. BMS for ULM disease.
Methods: We performed a meta-analysis of studies examining ULM stenting with a follow-up duration of at least 3 years. We included the following end-points: all cause-mortality, myocardial infarction (MI), and target-lesion revascularization (TLR). In addition, we examined the rates of major adverse cardiac events (MACE) as specified by each individual study. Pooled risk ratios (RR) and their 95% confidence intervals (CI) were calculated for all outcomes using a random-effect model.
Results: Thirteen studies were included in the analysis: 12 observational and 1 randomized study, with a total of 4,574 patients. We analyzed separately adjusted and unadjusted data. The adjusted data included a randomized trial and propensity-matched analysis of observational studies. Both analyses showed the benefit of DES for TLR (A p=0.004, UA p<0.001) and MACE (A p=0.02, UA p=0.007). While the unadjusted analysis showed a significant difference for all-cause mortality, the difference was not significant for the adjusted data. Neither of the analyses showed a significant difference for MI (Figure 1a and 1b).
Conclusions: The study confirms the benefits of DES for TVR and MACE but there was no significant difference in adjusted all-cause mortality.
Author Disclosures: C.A. Gongora: None. A. Lemor: None. A. Casso Dominguez: None. A. Zulbaran y Rojas: None. J. Pena: None. C. Bavishi: None. S. Arora: None. H. Ul Hassan: None. F. Gholitabar: None. S. Lee: None. F. Vallejo: None. S. Hosseinidehkordi: None. E. Argulian: None.
- © 2016 by American Heart Association, Inc.