Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Apr 23;172(8):611-21; discussion 621-2.
doi: 10.1001/archinternmed.2012.758.

Drug-eluting vs bare-metal stents in primary angioplasty: a pooled patient-level meta-analysis of randomized trials

Giuseppe De Luca  1 , Maurits T Dirksen, Christian Spaulding, Henning Kelbaek, Martin Schalij, Leif Thuesen, Bas van der Hoeven, Marteen A Vink, Christoph Kaiser, Carmine Musto, Tania Chechi, Gaia Spaziani, Luis Salvador Díaz de la Llera, Vincenzo Pasceri, Emilio Di Lorenzo, Roberto Violini, Giuliana Cortese, Harry Suryapranata, Gregg W Stone; Drug-Eluting Stent in Primary Angioplasty (DESERT) Cooperation
Collaborators, Affiliations
Review

Drug-eluting vs bare-metal stents in primary angioplasty: a pooled patient-level meta-analysis of randomized trials

Giuseppe De Luca et al. Arch Intern Med. .

Abstract

Background: Concerns have emerged regarding a higher risk of stent thrombosis after drug-eluting stent (DES) implantation, especially in the setting of ST-segment elevation myocardial infarction (STEMI). Our objective was to perform a meta-analysis using individual patient data to evaluate the long-term safety and effectiveness of DES compared with bare-metal stents (BMS) in patients undergoing primary percutaneous coronary intervention for STEMI.

Data sources: Formal searches of electronic databases (MEDLINE and CENTRAL) and scientific session presentations from January 2000 to June 2011.

Study selection: We examined all completed randomized trials of DES for STEMI.

Data extraction: Individual patient data.

Data synthesis: Individual patient data were obtained from 11 of 13 trials identified, including a total of 6298 patients (3980 [63.2%] randomized to DES [99% sirolimus-eluting or paclitaxel-eluting stents] and 2318 [36.8%] randomized to BMS). At long-term follow-up (mean [SD], 1201 [440] days), DES implantation significantly reduced the occurrence of target-vessel revascularization (12.7% vs 20.1%; hazard ratio [95% CI], 0.57 [0.50-0.66]; P < .001, P value for heterogeneity, .20), without any significant difference in terms of mortality, reinfarction, and stent thrombosis. However, DES implantation was associated with an increased risk of very late stent thrombosis and reinfarction.

Conclusions: The present pooled patient-level meta-analysis demonstrates that among patients with STEMI undergoing primary percutaneous coronary intervention, sirolimus-eluting and paclitaxel-eluting stents compared with BMS are associated with a significant reduction in target-vessel revascularization at long-term follow-up. Although there were no differences in cumulative mortality, reinfarction, or stent thrombosis, the incidence of very late reinfarction and stent thrombosis was increased with these DES.

PubMed Disclaimer

Comment in

MeSH terms