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. 2022 Aug 23:9:925912.
doi: 10.3389/fcvm.2022.925912. eCollection 2022.

Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis

Yang Chen  1 , Dandan Li  2 , Yanhui Liao  1 , Xiongda Yao  1 , Yuehua Ruan  1 , Kai Zou  1 , Hanhui Liao  1 , Jingwen Ding  1 , Hao Qin  1 , Zuozhong Yu  1 , Yuanbin Zhao  1 , Longlong Hu  1 , Renqiang Yang  1
Affiliations

Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis

Yang Chen et al. Front Cardiovasc Med. .

Abstract

Background: Reported evidence of coronary stent fracture (CSF) has increased in recent years. The purpose of this study was to determine reliable estimates of the overall incidence of CSF.

Methods and results: The MEDLINE, Embase and Cochrane databases were searched until March 18, 2022. Pooled estimates were acquired using random effects models. Meta-regression and subgroup analysis were used to explore sources of heterogeneity, and publication bias was evaluated by visual assessment of funnel plots and Egger's test. Overall, 46 articles were included in this study. Estimates of CSF incidence were 5.5% [95% confidence interval (CI): 3.7-7.7%] among 39,953 patients based on 36 studies, 4.8% (95% CI: 3.1-6.8%) among 39,945 lesions based on 29 studies and 4.9% (95% CI: 2.5-9.4%) among 19,252 stents based on 8 studies. There has been an obvious increase in the incidence of CSF over the past two decades, and it seems that the duration of stent placement after stent implantation has no impact on incidence estimation.

Conclusion: The incidence of CSF was 5.5% among patients, 4.8% for lesions and 4.9% for stents and increased over the past 20 years. The duration of stent placement after stent implantation was found to have no impact on the incidence of CSF, but drug-eluting stent (DES) types and right coronary artery (RCA) lesions influenced the pooled incidence.

Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022311995], identifier [CRD42022311995].

Keywords: drug-eluting stent; incidence; meta-analysis; meta-regression; stent fracture.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of included/excluded studies.
FIGURE 2
FIGURE 2
Forest plots of incidence of coronary stent fracture in patient level (A), incidence of stent fracture in lesion level (B) and incidence of stent fracture in stent level (C). CI, confidence interval.
FIGURE 3
FIGURE 3
Forest plots of incidence of coronary stent fracture in patient level in different DES type. BES, biolimus-eluting stent; CI, confidence interval; DES, drug-eluting stent; EES, everolimus-eluting stent; PES, paclitaxel-eluting stent; SES, sirolimus-eluting stent.
FIGURE 4
FIGURE 4
Forest plots of morbidity of coronary stent fracture in patient level in different follow up modes. CAG, coronary angiography; CI, confidence interval; CT, computed tomography; CTA, computed tomography angiography; IVUS, intravascular ultrasound; OCT, optical coherence tomography.
FIGURE 5
FIGURE 5
Forest plots of morbidity of coronary stent fracture in patient level in randomized and observational studies. CI, confidence interval.
See this image and copyright information in PMC

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