Abstract
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 + or - 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.
Highlights
Title Comparison by meta-analysis of drug-eluting stents and bare metal stents for saphenous vein graft intervention
The present analysis revealed that patients who underwent saphenous vein graft (SVG) intervention with drug-eluting stents (DESs) had lower mortality by 22% compared to the mortality rate of the patients with bare metal stents (BMSs)
The results of the present meta-analysis of 19 studies comparing DESs and BMSs in SVG intervention have indicated that the use of DESs in these patients provides superior clinical outcomes compared to BMS use
Summary
Title Comparison by meta-analysis of drug-eluting stents and bare metal stents for saphenous vein graft intervention. Dr Lee is a member of the Speaker’s Bureau for Schering-Plough, Kenilworth, New Jersey, Boston Scientific Corporation, Boston, Massachusetts, and Bristol-Myers Squibb, New York, New York. Dr Tobis is a member of the Speaker’s Bureau for Boston Scientific Corporation, Boston, Massachusetts. Dr Mahmud has received research grants for clinical trials from Boston Scientific, Boston, Massachusetts, and Abbott Vascular, and is on the Speakers List for Medtronic. Dr Liao is an employee of Boston Scientific Corporation, Boston, Massachusetts
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