Efficiency and safety of drug-eluting stents and bare metal stents in elderly coronary artery disease： Meta-analysis / 中国介入影像与治疗学

ABSTRACT

Objective To evaluate the efficiency and safety of drug-eluting stents (DES) and bare metal stents (BMS) in elderly with coronary artery disease (CAD).Methods PubMed,Embase,Cochrane Library,CNKI and Wanfang databases were searched before October 28,2017.The pertinent randomized controlled trials (RCTs) and cohort studies (CS) were included.The outcomes were all-cause mortality (ACM),myocardial infarction (MI),target vessel revascularization (TVR),cardiac death (CD),stent thrombosis (ST) and bleeding.Relative risk (RR) with 95％ confidence interval (95％CI) was analyzed.Results A total of 17 studies with 10 813 patients were included.Overall and in CS group,there were significant lower risks of ACM (RR＝0.71,0.68,both P＜0.001),MI (RR＝0.66,P＜0.001;RR＝0.60,P＝0.008),TVR (RR＝0.50,0.54,both P＜0.001),CD (RR＝0.73,0.72,P＝0.003,0.020) and ST (RR＝0.68,0.59,P＝ 0.02,0.01) in DES patients compared with BMS patients,but the risk of bleeding was not significantly different (RR ＝ 1.00,1.00,P ＝ 0.96,0.97).In RCT group,DES (compared with BMS) was only associated with significantly lower risks of MI (RR＝0.68,P＝0.003) and TVR (RR＝0.43,P＜0.001),no difference was detected in other indexes.Conclusion DES is more efficacious and safer than BMS for elderly patients with CAD.