Drug-eluting stents reduce restenosis rates and major adverse cardiac events, but not mortality, in patients undergoing percutaneous coronary intervention

Abstract

Do drug-eluting stents reduce restenosis rates and major adverse cardiac events compared with bare-metal stents in people having percutaneous coronary intervention? Systematic review with meta-analysis. Eleven trials met inclusion criteria. In the first 12 months, drug-eluting stents containing paclitaxel or sirolimus did not reduce rate of death or heart attack compared with bare-metal stents (see Results table). Drug-eluting stents significantly decreased the rates of target-lesion revascularisation and major adverse cardiac events compared with bare-metal stents. The rate of angioplastic restenosis was significantly lower in people receiving drug-eluting stents (drug-eluting stent V bare-metals stent: OR 0.2, 95%CrI 0.1 to 0.4). There was no significant difference in edge stenosis between groups (drug-eluting stent V bare-metals stent: OR 1.4, 95%CrI 0.5 to 2.86). Stents that elute paclitaxel or sirolimus significantly lower the medium-term rates of restenosis and major adverse cardiac events compared with bare-metal stents in people who have percutaneous coronary intervention. The lower rate of major cardiovascular events is entirely due to a reduction in the rate of target-lesion revascularisation, as drug-eluting stents do not reduce the rate of heart attack or death.