Author + information
- Rahman Shaha,b,
- Muhammad Shahreyara,b,
- Abdul Rashida,b,
- Mohamed Morsya,b,
- Inyong Hwanga,b,
- Beatrix Ramos Bondya,b and
- Mark Hecklea,b
Background: All randomized controlled trials (RCTs) comparing drug-eluting stents (DESs) with bare metal stents (BMSs) for saphenous vein graft (SVG) interventions have been small- to medium-sized. Individual trials have been criticized because sample sizes were small and statistical powers were low. A recently-reported RCT prompted us to update a comprehensive meta-analysis of these RCTs, now including the largest sample size ever reported.
Methods: Relevant RCTs were included, and pooled risk ratios (RRs) were calculated using fixed-effect models. Additional sensitivity analyses were done using random-effect models.
Results: Data from five RCTs showed that SVG intervention with a DES reduced MACE rate (RR, 0.72; 95% CI, 0.58-0.90; P = 0.004), target vessel revascularization (TVR; RR, 0.58; 95% CI, 0.42-0.78; P < 0.001) and target lesion revascularization (TLR; RR, 0.54; 95% CI, 0.35-0.81; P =0.004) compared to BMS. No differences between the stents were found in rates of stent thrombosis (RR, 0.52; 95% CI, 0.16-1.70; P = 0.284), recurrent MI (RR, 0.64; 95% CI, 0.39-1.04; P = 0.076), or all-cause mortality (RR, 1.25; 95% CI, 0.71-2.19; P = 0.437). Sensitivity analysis using a random-effects model showed TVR remained significant, favoring DES.
Conclusions: For SVG intervention, DES decreases MACE rate predominately driven by a reduced TVR rate. Rates of recurrent MI, stent thrombosis, and all-cause mortality were not different between the stents.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Revascularization and Myocardial Preservation in Acute and Stable Ischemic Heart Disease
Abstract Category: 22. Interventional Cardiology: Coronary Intervention: Left Main, Multivessel, Bifurcation Presentation Number: 1165-311
- 2017 American College of Cardiology Foundation