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Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Kumar, Manoj; Kumar, Nomesh; Upreti, Prakash; Zaka Haider, Mobeen; Naser, Abdallah; Basit, Salman Abdul; Turkmani, Mustafa; Rajak, Kripa; Bahar, Yasemin; Hamza, Mohammad; Sattar, Yasar; Alraies, M Chadi.
Afiliación
  • Kumar M; John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
  • Kumar N; Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
  • Upreti P; Sands Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
  • Zaka Haider M; Department of Internal Medicine, Carle Foundation Hospital, Carle Illinois College of Medicine, Urbana, IL, USA.
  • Naser A; Department of Internal Medicine, Allegheny Health Network, PA, USA.
  • Basit SA; The Wright Center for GME, Scranton, PA, USA.
  • Turkmani M; Michigan State University, East Lansing. Department of Internal Medicine, McLaren Healthcare, Oakland, MI, USA.
  • Rajak K; Dept of Internal Medicine, University of Pittsburgh Medical Center, PA, USA.
  • Bahar Y; Wayne State University, Detroit, MI, USA.
  • Hamza M; Department of Internal Medicine, Guthrie Medical Group, Cortland, NY, USA.
  • Sattar Y; Department of Cardiology, West Virginia University, Morgantown, WV, USA.
  • Alraies MC; Cardiovascular Institute, Detroit Medical Center, DMC Heart Hospital, Detroit, MI, USA. Electronic address: alraies@hotmail.com.
Int J Cardiol ; 412: 132269, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-38880417
ABSTRACT

INTRODUCTION:

In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.

METHODS:

Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).

RESULTS:

Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR 0.45, 95% CI 0.31-0.64, p-value <0.0001), and target lesion revascularization (TLR) (RR 0.59, 95%CI 0.44-0.78, p-value 0.0002) compared to BA. However, all-cause mortality, cardiovascular mortality, incidence of myocardial infarction (MI), and target lesion thrombosis were not different between the two intervention arms.

CONCLUSION:

DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR. No difference in mortality, risk of MI, or target lesion thrombosis was observed between the two interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angioplastia Coronaria con Balón / Ensayos Clínicos Controlados Aleatorios como Asunto / Reestenosis Coronaria / Stents Liberadores de Fármacos Límite: Humans Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Angioplastia Coronaria con Balón / Ensayos Clínicos Controlados Aleatorios como Asunto / Reestenosis Coronaria / Stents Liberadores de Fármacos Límite: Humans Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos