Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts A Meta-Analysis 英文参考文献.docVIP

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Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts A Meta-Analysis 英文参考文献.doc

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Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts A Meta-Analysis 英文参考文献

Drug-ElutingversusBare-MetalStentforTreatmentof SaphenousVeinGrafts:AMeta-Analysis PascalMeier1,2,EmmanouilS.Brilakis3,RobertoCorti4,GuidoKnapp5,MehdiH.Shishehbor6,HitinderS. Gurm1,2 * 1UniversityofMichiganMedicalCenter,AnnArbor,Michigan,UnitedStatesofAmerica,2VeteransAffairsAnnArborHealthcareSystem,AnnArbor,Michigan,United States of America, 3Division of Cardiovascular Diseases, Veterans Affairs North Texas Healthcare System, Dallas, Texas, United States of America, 4Department of Cardiology,UniversityHospitalZurich,Zurich,Switzerland,5DepartmentofStatistics,TUDortmundUniversity,Dortmund,Germany,6CardiovascularMedicine,Cleveland ClinicFoundation,Cleveland,Ohio,UnitedStatesofAmerica Abstract Background:Saphenousveingraftsdevelopanaggressiveatheroscleroticprocessandtheefficacyofdrugelutingstents (DES)intreatingsaphenousveingraft(SVG)lesionshasnotbeenconvincinglydemonstrated.Theaimofthisstudywasto reviewandanalyzethecurrentliteratureforcontrolledstudiescomparingDESversusbaremetalstents(BMS)fortreatment ofSVGstenoses. Methodology/Principal Findings: Wesearchedseveralscientific databasesandconference proceedingsuptoMarch 15, 2010forcontrolledstudiescomparingtargetvesselrevascularization(TVR)betweenDESandBMS.Summaryoddsratios (OR)fortheprimaryendpointTVRandsecondaryendpointsinfarction,stentthrombosisanddeathwerecalculatedusing random-effectmodels.Atotalof29studies(3randomizedcontrolledtrialsRCT)involving7549(202inRCT)patientswere included.TheneedfortargetvesselrevascularizationintheDESgrouptendedtobelowercomparedtoBMSforthe3RCT (OR0.50[0.24–1.00];p=0.051)andforobservationalstudies(0.62[0.49–0.79];p,0.001).Therewasnosignificantdifference in the risk for myocardial infarction in the RCT (OR 1.25 [0.22–6.99]; p=0.250) but a lower risk for DES based on the observationalstudies0.68[0.49–0.95];p=0.023.Theriskforstentthrombosiswasfoundtobenon-differentintheRCT(OR 0.78 [0.03–21.73], p=0.885) while it was in favor of DES in the observational studies (0.58 [0.38 – 0.84]; p,0.