Late stent malapposition risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis
| Autor: | Theo Stijnen, Ayman K.M. Hassan, Sandrin C. Bergheanu, Martin J. Schalij, J. Wouter Jukema, Jaapjan D. Snoep, Bas L. van der Hoeven, Josepha W.M. Plevier |
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| Rok vydání: | 2009 |
| Předmět: |
Bare-metal stent
Male medicine.medical_specialty Paclitaxel medicine.medical_treatment Coronary Artery Disease law.invention Meta-analysis Late stent malapposition Late stent thrombosis Drug-eluting stents intravascular ultrasound analysis randomized clinical-trials coronary-thrombosis double-blind ii trial future-i sirolimus apposition metaanalysis lesions Coronary artery disease Randomized controlled trial law Risk Factors medicine Humans Zotarolimus Aged Randomized Controlled Trials as Topic Sirolimus Everolimus business.industry Graft Occlusion Vascular Stent Drug-Eluting Stents Middle Aged medicine.disease equipment and supplies Tubulin Modulators Surgery Prosthesis Failure Drug-eluting stent Female Stents Radiology Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Heart Journal, 31(10), 1172-1180 |
| ISSN: | 1522-9645 |
| Popis: | Aims Late stent malapposition (LSM) may be acquired (LASM) or persistent. LSM may play a role in patients who develop late stent thrombosis (ST). Our objective was to compare the risk of LASM in bare metal stents (BMS) with drug-eluting stents (DES) and to investigate the possible association of both acquired and persistent LSM with (very) late ST. Methods and results We searched PubMed and relevant sources from January 2002 to December 2007. Inclusion criteria were: (a) intra-vascular ultrasonography (IVUS) at both post-stent implantation and follow-up; (b) 6-9-month-follow-up IVUS; (c) implantation of either BMS or the following DES: sirolimus, paclitaxel, everolimus, or zotarolimus; and (d) follow-up for LSM. Of 33 articles retrieved for detailed evaluation, 17 met the inclusion criteria. The risk of LASM in patients with DES was four times higher compared with BMS (OR = 4.36, CI 95% 1.74-10.94) in randomized clinical trials. The risk of (very) late ST in patients with LSM (five studies) was higher compared with those without LSM (OR = 6.51, CI 95% 1.34-34.91). Conclusion In our meta-analysis, the risk of LASM is strongly increased after DES implantation compared with BMS. Furthermore, LSM seems to be associated with late and very late ST. |
| Databáze: | OpenAIRE |
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