[Drug-eluting stents in coronary heart disease]

Pichon Riviere A, Augustovski F, Garcia Marti S, Alcaraz A, Glujovsky D, Lopez A, Rey-Ares L, Bardach A, Ciapponi A, Urtasun M, Klein K
Record ID 32014000251
Spanish
Authors' objectives: To assess the available evidence on the efficacy, safety and coverage policies of the use of drug-eluting stents in coronary disease.
Authors' recomendations: There is high quality evidence identifying DES as safe and efficacious for the treatment of stable chronic or acute coronary disease. The use of DES has been associated to a lower incidence of revascularization and myocardial infarction when compared with CS, with no differences in overall mortality or intra-stent thrombosis. In multiple vessel disease, moderate quality evidence showed the non superiority of DES versus the treatment of choice represented by MRS. In left main coronary artery lesions, moderate quality evidence showed a higher need for revascularization with the use of DES versus MRS, with no differences in the development of fatal and non fatal clinical events. However, DES was associated to a lower overall mortality, AMI and revascularization when compared with CS. High quality evidence associated the treatment of chronic occlusive coronary lesions and ISR using DES with a lower need for revascularization, no differences in the development of overall mortality, AMI or intra-stent thrombosis when compared with conventional treatment alternatives. In the diabetic population with left main coronary artery disease or multiple vessel disease, moderate quality evidence associated the use of DES to a higher need for revascularization but a lower incidence of stroke when compared with MRS (treatment of choice). High quality evidence associated a lower need for revascularization with the use of DES when compared with CS. The identified clinical practice guidelines, health technology assessments and coverage policies suggest the use of DES only in complex lesions if anti-platelet therapy can be implemented.
Details
Project Status: Completed
Year Published: 2013
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Coronary Disease
Contact
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.