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Efficacy and safety of drug-eluting stents in patients with acute ST-segment-elevation myocardial infarction: a meta-analysis of randomized controlled trials Hao PP; Chen YG; Wang XL; Zhang YTex Heart Inst J 2010[]; 37 (5): 516-24We compared the efficacy and safety of drug-eluting stents with that of bare-metal stents in patients who experienced acute ST-segment-elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention. To do this, we performed a meta-analysis of 13 randomized controlled trials in which drug-eluting stents were compared with bare-metal stents in STEMI patients. The trials involved 6,769 patients (4,246 received drug-eluting stents and 2,523 received bare-metal stents) and follow-up periods of 6 to 48 months. In comparison with bare-metal stents, drug-eluting stents significantly reduced the incidence of major adverse cardiac events, with a risk ratio (RR) of 0.59 (95% confidence interval [CI], 0.47-0.73; P < 0.00001). Drug-eluting stents were not associated with a significant reduction in overall death (RR = 0.94; 95% CI, 0.74-1.20; P = 0.64), but were associated with significant reductions in recurrent myocardial infarction (RR = 0.76; 95% CI, 0.58-0.98; P = 0.03), target-vessel revascularization (RR = 0.47; 95% CI, 0.39-0.56; P <0.00001), and in-stent restenosis (RR = 0.32; 95% CI, 0.25-0.39; P < 0.00001). Moreover, no significant difference was found in the comparative risk of stent thrombosis (RR = 0.85; 95% CI, 0.63-1.14; P = 0.27).On the basis of risk ratio, we conclude that using drug-eluting stents in STEMI patients who undergo primary percutaneous coronary intervention is safe with regard to stent thrombosis within 48 months, and that drug-eluting stents improve clinical outcomes by reducing the risks of major adverse cardiac events, recurrent myocardial infarction, reintervention, and in-stent restenosis, compared with bare-metal stents. However, in order to investigate possible very late stent thrombosis, follow-up of these trials beyond 48 months is warranted.|*Drug-Eluting Stents[MESH]|*Stents[MESH]|Angioplasty, Balloon, Coronary/adverse effects/*instrumentation/mortality[MESH]|Chi-Square Distribution[MESH]|Coronary Restenosis/etiology/prevention & control[MESH]|Evidence-Based Medicine[MESH]|Humans[MESH]|Metals[MESH]|Middle Aged[MESH]|Myocardial Infarction/mortality/*therapy[MESH]|Odds Ratio[MESH]|Prosthesis Design[MESH]|Randomized Controlled Trials as Topic[MESH]|Recurrence[MESH]|Risk Assessment[MESH]|Risk Factors[MESH]|Thrombosis/etiology/prevention & control[MESH]|Time Factors[MESH]|Treatment Outcome[MESH] |
