A meta-analysis of randomized trials on clinical outcomes of paclitaxel-eluting stents versus bare-metal stents in ST-segment elevation myocardial infarction patients |
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| Authors: | Xiao-hong Pan Ying-xue Chen Mei-xiang Xiang Geng Xu and Jian-an Wang |
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| Institution: | Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China |
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| Abstract: | A meta-analysis was performed to address the efficacy and safety of paclitaxel-eluting stent (PES) in ST-segment elevation
myocardial infarction (STEMI) patients. A systematic literature search was conducted to identify all randomized clinical trials
in mortality, recurrent myocardial infarction (rMI), repeat revascularization (RR), and stent thrombosis (ST). A total of
4190 STEMI patients were enrolled in six randomized trials comparing PES with bare-metal stent (BMS). The pooled repeat revascularization
rate was 5.7% in PES group, significantly lower than 10.0% in BMS group with an odds ratio (OR) of 0.56, 95% confidence interval
(CI) 0.44, 0.72] (P<0.00001). No significant difference was found between PES and BMS groups in mortality at one year after the indexing procedure
(3.9% vs. 5.1%, OR 0.88, 95% CI 0.63, 1.21], P=0.42). Similarly, rMI rate did not differ significantly between the two groups (3.4% vs. 4.1%, OR 0.80, 95% CI 0.56, 1.13],
P=0.21). PES was also associated with the comparable pooled rate of definite stent thrombosis with BMS (2.3% vs. 2.4%, OR 0.81,
95% CI 0.52, 1.26], P=0.35). The results show that PES improved clinical outcomes in STEMI patients with a decreased need for repeat revascularization
and no concerns for safety. |
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| Keywords: | Myocardial infarction Paclitaxel-eluting stent Bare-metal stent Meta-analysis |
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