Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials

Zhu, Michael M; Feit, Alan; Chadow, Hal; Alam, Mahmood; Kwan, Tak; Clark, Luther T.

doi:10.1016/s0002-9149(01)01645-9

Cited by 148 publications

(89 citation statements)

References 11 publications

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“…110 Compared with balloon angioplasty, routine BMS implantation during primary PCI decreases risk for TVR and possibly reduces MI rates but does not reduce mortality rates. 111,112 Two-year data from the Massachusetts registry 113 from 1221 propensity score-matched pairs of DES and BMS patients demonstrated a reduction in mortality and TVR rates with DES in primary PCI, and an analysis from the New York State registry 114 found a reduction in mortality rates but not TVR rates with DES. These reports were limited to patients treated More recently, several relatively small randomized clinical trials have shown an inconsistent efficacy for DES over BMS in primary PCI.…”

Section: Recommendations For the Use Of Stents In Stemimentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

111

101

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Section: Recommendations For the Use Of Stents In Stemimentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

111

101

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“…In relation to stenting versus simple angioplasty in AMI, this confirms the results of an earlier metaanalysis. 87 However, it must be acknowledged that the power of the studies or meta-analysis to detect a benefit in mortality, even if it existed, is low (see later for power calculation). Mortality may not therefore be a realistic outcome to consider in terms of these small studies, albeit the most important from the patient perspective.…”

Section: Mortalitymentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

143

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“…1,2 The introduction of drugeluting stents (DES) has greatly alleviated this problem, 3 and their use in coronary intervention has markedly increased. DES decreases angiographic and clinical measurements of restenosis compared with bare metal stents 4,5 in elective patients and those with STEMI.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Sirolimus‐ and Paclitaxel‐Eluting Stents in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Elevation Myocardial Infarction: A Meta‐analysis of Randomized Trials

Zheng

Lu³

et al. 2010

Clinical Cardiology

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Background: It has been reported that sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have been more effective than bare-metal stents in reducing restenosis and cardiac events in a broad range of patients with coronary artery disease. However, it is unknown whether there might be differences between these two drug-eluting stents in terms of efficacy and safety in the setting of acute ST-segment elevation myocardial infarction (STEMI). Hypothesis: The aim of the present study was to compare SES with PES in patients with acute STEMI undergoing primary percutaneous coronary intervention (PCI). Methods: The published research was scanned by formal searches of electronic databases (PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials) from January 2001 to February 2010. Internet-based sources of information on the results of clinical trials in cardiology were also searched. Results: A total of 4 randomized trials were included in the present meta-analysis, involving 1105 patients (550 in the SES group, 555 in the PES group). SES were significantly more effective in the reduction of angiographic binary (≥50%) restenosis (4.0% vs 9.6%, odds ratio 0.38, 95% confidence interval 0.19 to 0.74, P = 0.004) compared to PES. The differences between SES and PES were not statistically significant with respect to target vessel revascularization (TVR), stent thrombosis, cardiac death, and myocardial infarction. Conclusions: SES are superior to PES in reducing the incidence of restenosis in patients undergoing primary PCI for STEMI, with nonsignificant differences in terms of TVR, cardiac death, myocardial infarction, and stent thrombosis. IntroductionPrimary angioplasty has become the standard of care for acute ST-segment elevation myocardial infarction (STEMI); however, its long-term success is limited by the occurrence of restenosis. 1,2 The introduction of drugeluting stents (DES) has greatly alleviated this problem, 3 and their use in coronary intervention has markedly increased. DES decreases angiographic and clinical measurements of restenosis compared with bare metal stents 4,5 in elective patients and those with STEMI. A meta-analysis in a broad population has shown that sirolimus-eluting stents (SES) are superior to paclitaxel-eluting stents (PES) in terms of late loss and target lesion revascularization (TLR). 6 However, the relative efficacy and safety of SES and PES in STEMI patients remains unclear. We therefore performed a meta-analysis of randomized

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Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta-analysis of randomized clinical trials

Cited by 148 publications

References 11 publications

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Coronary artery stents: a rapid systematic review and economic evaluation

Comparison of Sirolimus‐ and Paclitaxel‐Eluting Stents in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Elevation Myocardial Infarction: A Meta‐analysis of Randomized Trials

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