Clinical outcomes of percutaneous coronary intervention for de novo lesions in small coronary arteries: A systematic review and network meta-analysis.

Autor:	Ma WR; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Chandrasekharan KH; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom., Nai CS; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Zhu YX; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Iqbal J; Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom., Chang S; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Cheng YW; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Wang XY; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China., Bourantas CV; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom., Zhang YJ; Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2022 Nov 14; Vol. 9, pp. 1017833. Date of Electronic Publication: 2022 Nov 14 (Print Publication: 2022).
DOI:	10.3389/fcvm.2022.1017833
Abstrakt:	Background: Percutaneous coronary intervention (PCI) has a well-established role in revascularization for coronary artery disease. We performed network meta-analysis to provide evidence on optimal intervention strategies for de novo lesions in small coronary arteries. Materials and Methods: Enrolled studies were randomized clinical trials that compared different intervention strategies [balloon angioplasty (BA), biolimus-coated balloon (BCB), bare-metal stent (BMS), new-generation drug-eluting stent (New-DES), older generation sirolimus-eluting stent (Old-SES), paclitaxel-coated balloon (PCB), and paclitaxel-eluting stent (PES)] for de novo lesions in small coronary arteries. The primary outcome was major adverse cardiac events (MACE). Results: A total of 23 randomized clinical trials comparing seven intervention devices were analyzed. In terms of the primary outcome, New-DES was the intervention device with the best efficacy [surface under the cumulative ranking curve (SUCRA), 89.1%; mean rank, 1.7], and the Old-SES [risk ratio (RR), 1.09; 95% confidence interval (CI), 0.45-2.64] and PCB (RR, 1.40; 95% CI, 0.72-2.74) secondary to New-DES, but there was no statistically significant difference between these three intervention devices. All DES and PCB were superior to BMS and BA for MACE in both primary and sensitivity analysis. For secondary outcomes, there was no association between all-cause mortality and myocardial infarction (MI) with any intervention strategy, and additionally, the findings of target lesion revascularization (TLR) were similar to the primary outcomes. Conclusion: Paclitaxel-coated balloon yielded similar outcomes to New-DES for de novo lesions in small coronary arteries. Therefore, this network meta-analysis may provide potential support for PCB as a feasible, effective, and safe alternative intervention strategy for the revascularization of small coronary arteries. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022338433]. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Ma, Chandrasekharan, Nai, Zhu, Iqbal, Chang, Cheng, Wang, Bourantas and Zhang.)
Databáze:	MEDLINE
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