[Drug-eluting stents versus bare-metal stents in acute myocardial infarction]

Choi DH, Lee SM, Suh HS, Song HJ, Jang EJ, Choi JE, Shon HJ, Kim JS, Ahn YG, Jung MH, Hwang HJ
Record ID 32014000417
Authors' recomendations: In this meta-analysis of 52,503 patients with STEMI from forty-nine studies including RCTs and observational studies, the use of DES compared with BMS was associated with a significant reduction in TVR and TLR. DES and BMS did not show any differences in adverse effects such as death or stent thrombosis in RCTs. The use of DES in RCTs was associated with a statistically significant reduction in the recurrence of myocardial infarction, but the significance level was within the margin. In observational studies, the use of DES was associated with a significant reduction in mortality compared with BMS. However, there were no differences between DES and BMS in recurrent myocardial infarction and stent thrombosis overall. The use of DES was related to a significant increase in stent thrombosis compared with BMS in the observational studies with over two years of follow-up. However, caution is needed to interpret this result because it is derived from observational studies and the evidence level was evaluated as "very low quality". The use of DES appears to cost more than BMS. However, since this study was very sensitive to the costs and proportions of patients without revascularization, additional studies are required to obtain more accurate estimates of the costs and the proportions of patients without revascularization after initial stenting. Large-scale, long term local RCTs or prospective studies of high quality are required to ascertain the clinical efficacy, safety, and economic effects of DES compared with BMS.
Project Status: Completed
Year Published: 2009
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: South Korea
MeSH Terms
  • Stents
  • Drug-Eluting Stents
Organisation Name: National Evidence-based healthcare Collaborating Agency
Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), Changkyung B/D 9F, Wonnam-dong 28-7, Jongno-gu, Seoul, South Korea
Contact Name: hta_neca@neca.re.kr
Contact Email: hta_neca@neca.re.kr
Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)
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