Safety and efficacy of second‐generation drug‐eluting stents compared with bare‐metal stents: An updated meta‐analysis and regression of 9 randomized clinical trials Article Swipe
Ahmed N. Mahmoud
,
Nikhil Shah
,
Islam Y. Elgendy
,
Nayan Agarwal
,
Akram Y. Elgendy
,
Amgad Mentias
,
Amr F. Barakat
,
Dhruv Mahtta
,
R. David Anderson
,
Anthony A. Bavry
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1002/clc.22855
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1002/clc.22855
The efficacy of second‐generation drug‐eluting stents (DES; eg, everolimus and zotarolimus) compared with bare‐metal stents (BMS) in patients undergoing percutaneous coronary intervention was challenged recently by new evidence from large clinical trials. Thus, we aimed to conduct an updated systematic review and meta‐analysis of randomized clinical trials (RCTs) evaluating the efficacy and safety of second‐generation DES compared with BMS . Electronic databases were systematically searched for all RCTs comparing second‐generation DES with BMS and reporting clinical outcomes. The primary efficacy outcome was major adverse cardiac events (MACE); the primary safety outcome was definite stent thrombosis. The DerSimonian and Laird method was used for estimation of summary risk ratios (RR). A total of 9 trials involving 17 682 patients were included in the final analysis. Compared with BMS, second‐generation DES were associated with decreased incidence of MACE (RR: 0.78, 95% confidence interval [CI]: 0.69‐0.88), driven by the decreased incidence of myocardial infarction (MI) (RR: 0.67, 95% CI: 0.48‐0.95), target‐lesion revascularization (RR: 0.47, 95% CI: 0.42‐0.53), definite stent thrombosis (RR: 0.57, 95% CI: 0.41‐0.78), and definite/probable stent thrombosis (RR: 0.54, 95% CI: 0.38‐0.80). The incidence of all‐cause mortality was similar between groups (RR: 0.94, 95% CI: 0.79‐1.10). Meta‐regression showed lower incidences of MI with DES implantation in elderly and diabetic patients ( P = 0.026 and P < 0.0001, respectively). Compared with BMS, second‐generation DES appear to be associated with a lower incidence of MACE, mainly driven by lower rates of target‐lesion revascularization, MI, and stent thrombosis. However, all‐cause mortality appears similar between groups.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1002/clc.22855
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/clc.22855
- OA Status
- bronze
- Cited By
- 19
- References
- 44
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2793916325
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2793916325Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/clc.22855Digital Object Identifier
- Title
-
Safety and efficacy of second‐generation drug‐eluting stents compared with bare‐metal stents: An updated meta‐analysis and regression of 9 randomized clinical trialsWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-01-01Full publication date if available
- Authors
-
Ahmed N. Mahmoud, Nikhil Shah, Islam Y. Elgendy, Nayan Agarwal, Akram Y. Elgendy, Amgad Mentias, Amr F. Barakat, Dhruv Mahtta, R. David Anderson, Anthony A. BavryList of authors in order
- Landing page
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https://doi.org/10.1002/clc.22855Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/clc.22855Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/clc.22855Direct OA link when available
- Concepts
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Medicine, Percutaneous coronary intervention, Mace, Relative risk, Internal medicine, Myocardial infarction, Randomized controlled trial, Confidence interval, Stent, Surgery, Incidence (geometry), Meta-analysis, Optics, PhysicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
19Total citation count in OpenAlex
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2025: 1, 2024: 2, 2023: 4, 2022: 2, 2021: 2Per-year citation counts (last 5 years)
- References (count)
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44Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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