Drug-Eluting Stents in Coronary Artery Disease: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Ruijie ¹ , LI Jing ² , CHEN Yucheng ¹ , ZENG Zhi ¹

1. Department of Cardiology; West China Hospital; Sichuan University; Chengdu 610041; China2. Chinese Evidence-Based Medicine Center/Clinical Epidemilolgy Resource and Training Center;

Corresponding author：

Keywords：

Drug eluting sents; Restenosis; Coronary artery disease; Meta-analysis

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Objective 　To evaluate the efficacy and safety of drug-eluting stents in treating patients with coronary artery disease compared with bare metal stents.
Methods 　MEDLINE, EMBASE, CBMdisc and other databases of clinical trials were searched for meta-analysis and randomized controlled trials (RCTs) both in Chinese and English language. Conference abstracts, personal reference lists, reference lists of retrieved studies and some websites were also searched. Statistical analysis was performed using RevMan 4.2 software.
Results 　Meta-analysis was performed on the results of 25 RCTs with 5 different drug-eluting stents. Seven trials evaluated efficacy and safety of sirolimus-eluting stent, the results of meta-analysis indicated that SES decreased rates in stent restenosis compared with bare metal stent, and therefore the target lesion revascularization and adverse cardiac event rates, no “catch up” were found. Eight trials compared a paclitaxel-eluting stent with bare metal stent, similar results were found, i.e. decreased stent restenosis rate, target lesion revascularization and adverse cardiac event rates in patients receiving paclitaxel-eluting stent compared with bare metal stent. Three trials compared CYPHERTM and TAXUS stents head to head, and the combined analysis showed a superiority of CYPHERTM to TAXUS. But available data can not draw a conclusion with regard to the effect of drug-eluting stents on mortality, occurrence of MI or stent thrombosis. Everolimus-eluting stent had the same performance as these two drug-eluting stents above, but because of a small sample size, no further conclusion can be made. Actinomycin D eluting stents and 7-hexanoyltaxol-eluting stents increased restenosis rate and stent thrombosis rate respectively. Poor performance limited further clinical trials of these two stents.
Conclusions 　Sirolimus-eluting stent and polymetric paclitaxel-eluting stent are efficient and safe in patients with coronary artery atherosclerosis. Sirolimus eluting stent CYPHERTM seems better than paclitaxel eluting stent TAXUS.

Citation： LI Ruijie,LI Jing,CHEN Yucheng,ZENG Zhi. Drug-Eluting Stents in Coronary Artery Disease: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2005, 05(7): 519-535. doi: Copy

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Chinese Journal of Evidence-Based Medicine

Drug-Eluting Stents in Coronary Artery Disease: A Meta-analysis

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