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Meta-Analysis
. 2005 Apr 18;2005(2):CD005313.
doi: 10.1002/14651858.CD005313.

Primary stenting versus primary balloon angioplasty for treating acute myocardial infarction

A J Nordmann  1 , H Bucher, P Hengstler, T Harr, J Young
Affiliations
Meta-Analysis

Primary stenting versus primary balloon angioplasty for treating acute myocardial infarction

A J Nordmann et al. Cochrane Database Syst Rev. .

Abstract

Background: Balloon angioplasty following myocardial infarction (MI) reduces death, non-fatal MI and stroke compared to thrombolytic reperfusion. However up to 50% of patients experience restenosis and 3% to 5% recurrent myocardial infarction. Therefore, primary stenting may offer additional benefits compared to balloon angioplasty in patients with acute myocardial infarction.

Objectives: To examine whether primary stenting compared to primary balloon angioplasty reduces clinical outcomes in patients with acute myocardial infarction.

Search strategy: We searched MEDLINE, EMBASE, Pascal, Index medicus and The Cochrane Controlled Trials Register (The Cochrane Library) from 1979 to March 2002.

Selection criteria: Randomised controlled trials of primary stenting or balloon angioplasty prior to the invasive procedure; intervention in native coronary arteries within 24 hours after onset of symptoms of myocardial infarction; report of death or reinfarction; and follow-up of at least 1 month. Trials were excluded when randomisation occurred after an invasive procedure and if they exclusively included patients with cardiogenic shock.

Data collection and analysis: Two reviewers independently selected and extracted data from identified trials. Outcomes included mortality, reinfarction, coronary artery bypass grafting, target vessel revascularization, need for vascular repair or blood transfusion. Peto odds ratios were calculated. To explore the stability of the overall treatment effect various sensitivity analyses were performed.

Main results: We included nine trials of 4433 participants. Odds ratios for mortality after stenting compared to balloon angioplasty at 30 days, 6 and 12 months were 1.16 (95% CI 0.78 to 1.73), 1.27 (95% CI 0.89 to 1.83), and 1.06 (95% CI 0.77 to 1.45). At 30 days, 6 and 12 months odds ratios for reinfarction after stenting compared to balloon angioplasty were 0.52 (95% CI 0.31 to 0.87), 0.67 (95% CI 0.45 to 1.00), and 0.67 (95% CI 0.45-0.98) and odds ratio for target vessel revascularization after stenting compared to balloon angioplasty were 0.45 (95%CI 0.34 to 0.60), 0.42 (95% CI 0.35 to 0.51), and 0.47 (95% CI 0.38 to 0.57). The odds ratio for post-interventional bleeding complications after stenting compared to balloon angioplasty was 1.34 (95% CI 0.95 to 1.88; test of heterogeneity p > 0.1).

Authors' conclusions: There is no evidence to suggest that primary stenting reduces mortality when compared to balloon angioplasty. Stenting seems to be associated with a reduced risk of reinfarction and target vessel revascularization, but potential confounding due to unbalanced post-interventional antithrombotic/anticoagulant therapies can not be ruled out on basis of this review.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
1.1
1.1. Analysis
Comparison 1 Mortality, Outcome 1 30 Day.
1.2
1.2. Analysis
Comparison 1 Mortality, Outcome 2 6 months.
1.3
1.3. Analysis
Comparison 1 Mortality, Outcome 3 12 Months.
2.1
2.1. Analysis
Comparison 2 Myocardial Infarction, Outcome 1 30 day.
2.2
2.2. Analysis
Comparison 2 Myocardial Infarction, Outcome 2 6 Month.
2.3
2.3. Analysis
Comparison 2 Myocardial Infarction, Outcome 3 12 Month.
3.1
3.1. Analysis
Comparison 3 Revascularisation, Outcome 1 30 Day.
3.2
3.2. Analysis
Comparison 3 Revascularisation, Outcome 2 6 Month.
3.3
3.3. Analysis
Comparison 3 Revascularisation, Outcome 3 12 Month.
3.4
3.4. Analysis
Comparison 3 Revascularisation, Outcome 4 Successful dilation.
4.1
4.1. Analysis
Comparison 4 Adverse events, Outcome 1 Bleeding.
See this image and copyright information in PMC

References

References to studies included in this review

GRAMI {published data only}
    1. Rodriguez A, Bernardi V, Fernandez M, et al. In‐hospital and late results of coronary stents versus conventional balloon angioplasty in acute myocardial infarction (GRAMI trial). Gianturco‐Roubin in Acute Myocardial Infarction. The American Journal of Cardiology 1998;81(11):1286‐91. - PubMed
Grines {published and unpublished data}
    1. Grines CL, Cox DA, Stone GW, et al. Coronary angioplasty with or without stent implantation for acute myocardial infarction. Stent Primary Angioplasty in Myocardial Infarction Study Group. New England Journal of Medicine 1999;341(26):1949‐56. - PubMed
Jaksch {published and unpublished data}
    1. Jaksch R, Niehus R, Knobloch W, Schiele T. PTCA versus stenting in acute myocardial infarction. European Heart Journal 1998;19(239):1341.
PASTA {published data only}
    1. Saito S, Hosokawa G, Tanaka S, Nakamura S. Primary stent implantation is superior to balloon angioplasty in acute myocardial infarction: final results of the primary angioplasty versus stent implantation in acute myocardial infarction (PASTA) trial. PASTA Trial Investigators. Catheterization and Cardiovascular Interventions 1999;48(3):262‐8. - PubMed
PRISAM {published and unpublished data}
    1. Kawashima A, Ueda K, Nishida Y, Inoue N, Tanaka S, Kato O, et al. Quantitative angiographic analysis of restenosis of primary stenting using wiktor stent for acute myocardial infarction: results form a multicenter randomized PRISAM study. Circulation 1999;100(suppl 1):1‐856.
Scheller {published and unpublished data}
    1. Scheller B, Hennen B, Severin‐Kneib S, et al. Long‐term follow‐up of a randomized study of primary stenting versus angioplasty in acute myocardial infarction. The American Journal of Medicine 2001;110(1):1‐6. - PubMed
STENTIM‐2 {published data only}
    1. Maillard L, Hamon M, Khalife K, et al. A comparison of systematic stenting and conventional balloon angioplasty during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction. STENTIM‐2 Investigators. Journal of the American College of Cardiology 2000;35(7):1729‐36. - PubMed
Stone {published and unpublished data}
    1. Stone GW, Grines CL, Cox DA, et al. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. New England Journal of Medicine 2002;346(13):957‐66. - PubMed
Suryapranata {published data only}
    1. Suryapranata H, Ottervanger JP, Nibbering E, et al. Long term outcome and cost‐effectiveness of stenting versus balloon angioplasty for acute myocardial infarction. Heart 2001;85(6):667‐71. - PMC - PubMed
    1. Suryapranata H, van't Hof AW, Hoorntje JC, et al. Randomized comparison of coronary stenting with balloon angioplasty in selected patients with acute myocardial infarction. Circulation 1998;97(25):2502‐5. - PubMed

References to studies excluded from this review

ADVANCE {published data only}
    1. Serruys PW, Foley DP, Suttorp MJ, et al. A randomized comparison of the value of additional stenting after optimal balloon angioplasty for long coronary lesions: final results of the additional value of NIR stents for treatment of long coronary lesions (ADVANCE) study. Journal of the American College of Cardiology 2002;39(3):393‐9. - PubMed
BENESTENT {published data only}
    1. Kiemeneij F, Serruys PW, Macaya C, et al. Continued benefit of coronary stenting versus balloon angioplasty: five‐year clinical follow‐up of Benestent‐I trial. Journal of the American College of Cardiology 2001;37(6):1598‐603. - PubMed
    1. Macaya C, Serruys PW, Ruygrok P, et al. Continued benefit of coronary stenting versus balloon angioplasty: one‐ year clinical follow‐up of Benestent trial. Benestent Study Group. Journal of the American College of Cardiology 1996;27(2):255‐61. - PubMed
    1. Serruys PW, Jaegere P, Kiemeneij F, et al. A comparison of balloon‐expandable‐stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. New England Journal of Medicine 1994;331(8):489‐95. - PubMed
    1. Serruys PW, Hout B, Bonnier H, et al. Randomised comparison of implantation of heparin‐coated stents with balloon angioplasty in selected patients with coronary artery disease (Benestent II). Lancet 1998;352:673‐81. - PubMed
BET {published data only}
    1. Carrie D, Khalife K, Citron B, et al. Comparison of direct coronary stenting with and without balloon predilatation in patients with stable angina pectoris. BET (Benefit Evaluation of Direct Coronary Stenting) Study Group. The American Journal of Cardiology 2001;87(6):693‐8. - PubMed
BOSS {published data only}
    1. Dangas G, Ambrose JA, Rehmann D, et al. Balloon optimization versus stent study (BOSS): provisional stenting and early recoil after balloon angioplasty. The American Journal of Cardiology 2000;85(8):957‐61. - PubMed
Brener {published data only}
    1. Brener SJ, Ellis SG, Apperson‐Hansen C, et al. Comparison of stenting and balloon angioplasty for narrowings in aortocoronary saphenous vein conduits in place for more than five years. The American Journal of Cardiology 1997;79(1):13‐8. - PubMed
Briguori {published data only}
    1. Briguori C, Nishida T, Adamian M, et al. Coronary stenting versus balloon angioplasty in small coronary artery with complex lesions. Catheterization and Cardiovascular Interventions 2000;50(4):390‐7. - PubMed
Cura {published data only}
    1. Cura FA, Bhatt DL, Lincoff AM, et al. Pronounced benefit of coronary stenting and adjunctive platelet glycoprotein IIb/IIIa inhibition in complex atherosclerotic lesions. Circulation 2000;102(1):28‐34. - PubMed
DESTINI {published data only}
    1. Mario C, Moses JW, Anderson TJ, et al. Randomized comparison of elective stent implantation and coronary balloon angioplasty guided by online quantitative angiography and intracoronary Doppler. DESTINI Study Group (Doppler Endpoint Stenting International Investigation). Circulation 2000;102(24):2938‐44. - PubMed
    1. Moussa I, Moses J, Mario C, et al. Selecting who qualifies for optimal balloon angioplasty versus elective stenting in coronary artery disease (a subanalysis of the DESTINI trial). The American Journal of Cardiology 2002;90(3):323‐5. - PubMed
Doucet {published data only}
    1. Doucet S, Schalij MJ, Vrolix MC, et al. Stent placement to prevent restenosis after angioplasty in small coronary arteries. Circulation 2001;104(17):2029‐33. - PubMed
Eeckhout {published data only}
    1. Eeckhout E, Stauffer JC, Vogt P, et al. Comparison of elective Wiktor stent placement with conventional balloon angioplasty for new‐onset lesions of the right coronary artery. American Heart Journal 1996;132(2 Pt 1):263‐8. - PubMed
Elezi {published data only}
    1. Elezi S, Kastrati A, Hadamitzky M, et al. Clinical and angiographic follow‐up after balloon angioplasty with provisional stenting for coronary in‐stent restenosis. Catheterization and Cardiovascular Interventions 1999;48(2):151‐6. - PubMed
EPISTENT {published data only}
    1. Marso SP, Lincoff AM, Ellis SG, et al. Optimizing the percutaneous interventional outcomes for patients with diabetes mellitus: results of the EPISTENT (Evaluation of platelet IIb/IIIa inhibitor for stenting trial) diabetic substudy. Circulation 1999;100(25):2477‐84. - PubMed
    1. The EPISTENT Investigators. Randomised placebo‐controlled and balloon‐angioplasty‐controlled trial to assess safety of coronary stenting with use of platelet glycoprotein‐ IIb/IIIa blockade. The EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting. Lancet 1998;352(9122):87‐92. - PubMed
Fischman {published data only}
    1. Fischman DL, Leon MB, Baim DS, et al. A randomized comparison of coronary‐stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent Restenosis Study Investigators. New England Journal of Medicine 1994;331(8):496‐501. - PubMed
FRESCO {published data only}
    1. Antoniucci D, Santoro GM, Bolognese L, et al. A clinical trial comparing primary stenting of the infarct‐related artery with optimal primary angioplasty for acute myocardial infarction: results from the Florence Randomized Elective Stenting in Acute Coronary Occlusions (FRESCO) trial. Journal of the American College of Cardiology 1998;31(6):1234‐9. - PubMed
FROST {published data only}
    1. Lafont A, Dubois‐Rande JL, Steg PG, et al. The French Randomized Optimal Stenting Trial: a prospective evaluation of provisional stenting guided by coronary velocity reserve and quantitative coronary angiography. F.R.O.S.T. Study Group. Journal of the American College of Cardiology 2000;36(2):404‐9. - PubMed
GISSOC {published data only}
    1. Rubartelli P, Niccoli L, Verna E, et al. Stent implantation versus balloon angioplasty in chronic coronary occlusions: results from the GISSOC trial. Gruppo Italiano di Studio sullo Stent nelle Occlusioni Coronariche. Journal of the American College of Cardiology 1998;32(1):90‐6. - PubMed
Gruberg {published data only}
    1. Gruberg L, Hong MK, Mehran R, et al. In‐hospital and long‐term results of stent deployment compared with balloon angioplasty for treatment of narrowing at the saphenous vein graft distal anastomosis site. The American Journal of Cardiology 1999;84(12):1381‐4. - PubMed
Hancock {published data only}
    1. Hancock J, Thomas MR, Holmberg S, et al. Randomised trial of elective stenting after successful percutaneous transluminal coronary angioplasty of occluded coronary arteries. Heart 1998;79(1):18‐23. - PMC - PubMed
ISAR‐SMART {published data only}
    1. Hausleiter J, Kastrati A, Mehilli J, et al. Comparative analysis of stent placement versus balloon angioplasty in small coronary arteries with long narrowings (the Intracoronary Stenting or Angioplasty for Restenosis Reduction in Small Arteries [ISAR‐SMART] Trial). The American Journal of Cardiology 2002;89(1):58‐60. - PubMed
    1. Kastrati A, Schomig A, Dirschinger J, et al. A randomized trial comparing stenting with balloon angioplasty in small vessels in patients with symptomatic coronary artery disease. ISAR‐ SMART Study Investigators. Intracoronary Stenting or Angioplasty for Restenosis Reduction in Small Arteries. Circulation 2000;102(21):2593‐8. - PubMed
Kastrati {published data only}
    1. Kastrati A, Dirschinger J, Boekstegers P, et al. Influence of stent design on 1‐year outcome after coronary stent placement: a randomized comparison of five stent types in 1,147 unselected patients. Catheterization and Cardiovascular Interventions 2000;50(3):290‐7. - PubMed
Katz {published data only}
    1. Katz S, Green SJ, Kaplan BM, et al. Nonrandomized comparison between stent deployment and percutaneous transluminal coronary angioplasty in acute myocardial infarction. American Heart Journal 2000;139(1 Pt 1):44‐51. - PubMed
Koning {published data only}
    1. Koning R, Eltchaninoff H, Commeau P, et al. Stent placement compared with balloon angioplasty for small coronary arteries: in‐hospital and 6‐month clinical and angiographic results. Circulation 2001;104(14):1604‐8. - PubMed
Kovar {published data only}
    1. Kovar LI, Monrad ES, Sherman W, et al. A randomized trial of stenting with or without balloon predilation for the treatment of coronary artery disease. American Heart Journal 2001;142(5):E9. - PubMed
Lincoff {published data only}
    1. Lincoff AM, Califf RM, Moliterno DJ, et al. Complementary clinical benefits of coronary‐artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. Evaluation of Platelet IIb/IIIa Inhibition in Stenting Investigators. New England Journal Medicine 1999;341(5):319‐27. - PubMed
Mehilli {published data only}
    1. Mehilli J, Kastrati A, Dirschinger J, et al. A randomized trial comparing the hand‐mounted JoStent with the premounted Multi‐Link Duet stent in patients with coronary artery disease. Catheterization and Cardiovascular Interventions 2001;54(4):414‐9. - PubMed
Miketic(a) {published data only}
    1. Miketic S, Carlsson J, Tebbe U. Randomized comparison of J&J Crown stent versus NIR stent after routine coronary angioplasty. American Heart Journal 2001;142(5):E8. - PubMed
Miketic(b) {published data only}
    1. Miketic S, Carlsson J, Tebbe U. Clinical and angiographic outcome after conventional angioplasty with optional stent implantation compared with direct stenting without predilatation. Heart 2002;88(6):622‐6. - PMC - PubMed
Mori {published data only}
    1. Mori M, Kurogane H, Hayashi T, et al. Comparison of results of intracoronary implantation of the Plamaz‐Schatz stent with conventional balloon angioplasty in chronic total coronary arterial occlusion. The American Journal of Cardiology 1996;78(9):985‐9. - PubMed
Niazi {published data only}
    1. Niazi K, Kinsara AJ, Amoudi O, Patel A, Buraiki J, Bakshi M, et al. Stents in small coronary vessels: A prospective, randomized study. Circulation Supplement 1999;I 100(18):I‐510. 2‐11‐0099.
OCBAS {published data only}
    1. Rodriguez A, Ayala F, Bernardi V, et al. Optimal coronary balloon angioplasty with provisional stenting versus primary stent (OCBAS): immediate and long‐term follow‐up results. Journal of the American College of Cardiology 1998;32(5):1351‐7. - PubMed
OPUS‐1 {published data only}
    1. Weaver WD, Reisman MA, Griffin JJ, et al. Optimum percutaneous transluminal coronary angioplasty compared with routine stent strategy trial (OPUS‐1): a randomised trial. Lancet 2000;355(9222):2199‐203. - PubMed
Prieto {published data only}
    1. Prieto AR, Przybysz A, Fischell TA. Long balloon angioplasty with focal stenting for the treatment of diffuse coronary artery disease. Catheterization and Cardiovascular Interventions 2002;57(4):437‐43. - PubMed
SARECCO {published data only}
    1. Sievert H, Rohde S, Utech A, et al. Stent or angioplasty after recanalization of chronic coronary occlusions? (The SARECCO Trial). The American Journal of Cardiology 1999;84(4):386‐90. - PubMed
Sasao {published data only}
    1. Sasao H, Endo A, Hasegawa T, et al. Long‐term follow‐up after coronary stent implantation in patients with coronary artery disease. Angiology 2002;53(2):149‐56. - PubMed
Savage {published data only}
    1. Savage MP, Douglas JS Jr, Fischman DL, et al. Stent placement compared with balloon angioplasty for obstructed coronary bypass grafts. Saphenous Vein De Novo Trial Investigators. New England Journal of Medicine 1997;337(11):740‐7. - PubMed
SICCO {published data only}
    1. Sirnes PA, Golf S, Myreng Y, et al. Stenting in Chronic Coronary Occlusion (SICCO): a randomized, controlled trial of adding stent implantation after successful angioplasty. Journal of the American College of Cardiology 1996;28(6):1444‐51. - PubMed
SISCA {published data only}
    1. Moer R, Myreng Y, Molstad P, et al. Stenting in small coronary arteries (SISCA) trial. A randomized comparison between balloon angioplasty and the heparin‐coated be stent. Journal of the American College of Cardiology 2001;38(6):1598‐603. - PubMed
START {published data only}
    1. Betriu A, Masotti M, Serra A, et al. Randomized comparison of coronary stent implantation and balloon angioplasty in the treatment of de novo coronary artery lesions (START): a four‐year follow‐up. Journal of the American College of Cardiology 1999;34(5):1498‐506. - PubMed
STOP {published data only}
    1. Lotan C, Rozenman Y, Hendler A, et al. Stents in total occlusion for restenosis prevention. The multicentre randomized STOP study. The Israeli Working Group for Interventional Cardiology. European Heart Journal 2000;21(23):1960‐6. - PubMed
STRESS I {published data only}
    1. George CJ, Baim DS, Brinker JA, et al. One‐year follow‐up of the Stent Restenosis (STRESS I) Study. The American Journal of Cardiology 1998;81(7):860‐5. - PubMed
Topol {published data only}
    1. Topol EJ, Mark DB, Lincoff AM, et al. Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting: results from a multicentre randomised trial. EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting. Lancet 1999;354(9195):2019‐24. - PubMed
TOSCA {published data only}
    1. Buller CE, Dzavik V, Carere RG, et al. Primary stenting versus balloon angioplasty in occluded coronary arteries: the Total Occlusion Study of Canada (TOSCA). Circulation 1999;100(3):236‐42. - PubMed
Versaci {published data only}
    1. Versaci F, Gaspardone A, Tomai F, et al. A comparison of coronary‐artery stenting with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery. New England Journal of Medicine 1997;336(12):817‐22. - PubMed
Waksman {published data only}
    1. Waksman R, Weintraub WS, Ghazzal Z, et al. Short‐ and long‐term outcome of narrowed saphenous vein bypass graft: a comparison of Palmaz‐Schatz stent, directional coronary atherectomy, and balloon angioplasty. American Heart Journal 1997;134(2 Pt 1):274‐81. - PubMed
WIDEST {published data only}
    1. Fluck DS, Chenu P, Mills P, et al. Is provisional stenting the effective option? The WIDEST study (Wiktor stent in de novo stenosis). Widest Trial Investigators' Group. Heart 2000;84(5):522‐8. - PMC - PubMed
Witkowski 2000 {published data only}
    1. Witkowski A, Ruzyllo W, Gil R, et al. A randomized comparison of elective high‐pressure stenting with balloon angioplasty: six‐month angiographic and two‐year clinical follow‐up. On behalf of AS (Angioplasty or Stent) trial investigators. American Heart Journal 2000;140(2):264‐71. - PubMed
Wong {published data only}
    1. Wong SC, Baim DS, Schatz RA, et al. Immediate results and late outcomes after stent implantation in saphenous vein graft lesions: the multicenter U.S. Palmaz‐Schatz stent experience. The Palmaz‐Schatz Stent Study Group. Journal of the American College of Cardiology 1995;26(3):704‐12. - PubMed

Additional references

Antoniucci 1998
    1. Antoniucci D, Santoro GM, Bolognese L, et al. A clinical trial comparing primary stenting of the infarct‐related artery with optimal primary angioplasty for acute myocardial infarction: results from the Florence Randomized Elective Stenting in Acute Coronary Occlusions (FRESCO) trial. Journal of the American College of Cardiology 1998;31(6):1234‐9. - PubMed
Berger 2001
    1. Berger PB, Dzavik V, Penn IM, et al. Does ticlopidine reduce reocclusion and other adverse events after successful balloon angioplasty of occluded coronary arteries? Results from the Total Occlusion Study of Canada (TOSCA). American Heart Journal 2001;142(5):776‐81. - PubMed
Bertrand 1998
    1. Bertrand ME, Legrand V, Boland J, et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (fantastic) study. Circulation 1998;98(16):1597‐603. - PubMed
Cicchetti 1990
    1. Cicchetti DV, Feinstein AR. High agreement but low kappa: II. Resolving the paradoxes. Journal fo Clinical Epidemiology 1990;43(6):551‐8. - PubMed
de Boer 1995
    1. Boer MJ, Hout BA, Liem AL, et al. A cost‐effective analysis of primary coronary angioplasty versus thrombolysis for acute myocardial infarction. American Journal of Cardiology 1995;76(11):830‐3. - PubMed
Deeks 1998
    1. Deeks, JJ, Bradburn, MJ, Localio, R, Berlin. J. Much ado about nothing: meta‐analysis for rare events. 6th Cochrane Colloquium Baltimore,MD,USA. 1998.
Egger 1997
    1. Egger M, Davey SG, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Hardy 1998
    1. Hardy RJ, Thompson SG. Detecting and describing heterogeneity in meta‐analysis. Statistics in Medicine 1998;17(8):841‐56. - PubMed
Jadad 1996
    1. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinincal Trials 1996;17(1):1‐12. - PubMed
Keeley 2003
    1. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. The Lancet 2003;361(9351):13‐20. - PubMed
Leon 1998
    1. Leon MB, Baim DS, Popma JJ, et al. A clinical trial comparing three antithrombotic‐drug regimens after coronary‐artery stenting. Stent Anticoagulation Restenosis Study Investigators. New England Journal of Medicine 1998;339(23):1665‐71. - PubMed
Mehta 2001
    1. Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreatment with clopidogrel and aspirin followed by long‐term therapy in patients undergoing percutaneous coronary intervention: the PCI‐CURE study. The Lancet 2001;358:527‐33. - PubMed
Morice 2002
    1. Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus‐eluting stent with a standard stent for coronary revascularization. New England Journal of Medicine 2002;346(23):1773‐80. - PubMed
Nunn 1999
    1. Nunn CM, O'Neill WW, Rothbaum D, et al. Long‐term outcome after primary angioplasty: report from the primary angioplasty in myocardial infarction (PAMI‐I) trial. Journal of the American College of Cardiology 1999;33(3):640‐6. - PubMed
Park 2000
    1. Park SW, Lee CW, Hong MK, et al. Randomized comparison of coronary stenting with optimal balloon angioplasty for treatment of lesions in small coronary arteries. European Heart Journal 2000;21(21):1785‐9. - PubMed
RevMan Analyses
    1. RevMan Analyses [Computer program].. Version 1.0 for Windows. In: Review Manager (RevMan) 4.2. Oxford, England: The Cochrane Collaboration, 2003..
Steinhubl 2002
    1. Steinhubl SR, Berger PB, Mann JT, III, et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002;288(19):2411‐20. - PubMed
Stone 1995
    1. Stone GW, Grines CL, Browne KF, et al. Implications of recurrent ischemia after reperfusion therapy in acute myocardial infarction: a comparison of thrombolytic therapy and primary angioplasty. Journal of the American College of Cardiology 1995;26(1):66‐72. - PubMed
Stone 1997
    1. Stone GW, Grines CL, Rothbaum D, et al. Analysis of the relative costs and effectiveness of primary angioplasty versus tissue‐type plasminogen activator: the Primary Angioplasty in Myocardial Infarction (PAMI) trial. The PAMI Trial Investigators. Journal of the American College of Cardiology 1997;29(5):901‐7. - PubMed
Sutton 2002
    1. Sutton AJ, Cooper NJ, Lambert PC, Jones DR, Abrams KP, Sweeting MJ. Meta‐analysis of rare and adverse event data.. Pharmacoeconomics & Outcomes Research 2002;2(4):367. - PubMed
ten Berg 2000
    1. Berg JM, Kelder JC, Suttorp MJ, et al. Effect of coumarins started before coronary angioplasty on acute complications and long‐term follow‐up: a randomized trial. Circulation 2000;102(4):386‐91. - PubMed
Urban 1998
    1. Urban P, Macaya C, Rupprecht HJ, et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high‐risk patients: the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation 1998;98(20):2126‐32. - PubMed
Zhu 2001
    1. Zhu MM, Feit A, Chadow H, et al. Primary stent implantation compared with primary balloon angioplasty for acute myocardial infarction: a meta‐analysis of randomized clinical trials. American Journal of Cardiology 2001;88(3):297‐301. - PubMed

References to other published versions of this review

Nordmann 2004
    1. Nordmann AJ, Hengstler P, Harr T, Young J, Bucher HC. Clinical outcomes of primary stenting versus balloon angioplasty in patients with myocardial infarction: a meta‐analysis of randomized controlled trials. American Journal of Medicine 2004;116(4):253‐62. - PubMed

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