The analysis compares mortality rates for drug-eluting stents (DES) versus bare metal stents (BMS) and the rates of myocardial infarction (MI) as well as target vessel revascularization (TVR). It includes approximately 190,000 patients from 56 studies and was conducted by a team of researchers led by Ajay J. Kirtane, Assistant Professor of Clinical Medicine; and Gregg W. Stone, Immediate Past Chairman of the Cardiovascular Research Foundation.
Kirtane and Stone conducted two parallel meta-analyses examining DES vs. BMS use in both randomized, controlled trials and in observational registry analyses. The overall analysis represents a systematic overview of "real-world" (comprising both on-label and off-label) DES use and incorporates a summary of both the published literature as well as several unpublished studies presented at major cardiovascular meetings.
The meta-analysis of 22 randomized trials included more than 9,000 patients with recent follow-up from previously published trials. According to the results, "DES resulted in no overall differences in death and MI, with a greater than 50% decrease in subsequent target vessel revascularization procedures," said Dr. Stone, adding that these findings are consistent with both on-label and off-label use of DES.
And in the 34-study observational meta-analysis (involving more than 180,000 "real-world" patients), "DES resulted in significant 22% and 13% reductions in death and MI, respectively, with a similar reduction in TVR (46%) as in the randomized trials, even after adjustment for confounding variables," said Dr. Stone. "These data are reassuring that DES are safe and effective for a wide-range of patients that are able to take dual antiplatelet therapy for at least one year."
MEDICA.de; Source: Cardiovascular Research Foundation