Individual Patient Data Meta-analysis of Drug-eluting Versus Bare-metal Stents for Percutaneous Coronary Intervention in Chronic Versus Acute Coronary Syndromes
Section snippets
Methods
This study is an individual patient data (IPD) meta-analysis of randomized clinical trials comparing new-generation DES versus BMS for PCI.10 The search algorithm of the study and the assembled anonymized dataset are shown in the Supplementary Material. We included randomized trials comparing new-generation DES versus BMS in patients who underwent PCI. New-generation DES were considered as any DES after the Cypher sirolimus-eluting stent (Cordis, Miami Lakes, Florida) and the Taxus
Results
Of the initial 26,616 participants, 4 trials (n = 3,629) were excluded because they enrolled only patients with ACS, and 246 patients were excluded because information on presenting coronary syndrome was missing. Therefore, the final population consisted of 22,319 patients enrolled across 14 trials; 7,691 patients (34.5%) with CCS and 14,628 patients (65.5%) with ACS. The Supplementary Material describes trial characteristics, patient populations, and the definitions used for outcomes (
Discussion
Using the totality of available evidence from randomized trials comparing new-generation DES with BMS, our collaborative IPD analysis provides strong evidence that DES reduce the risk of cardiac death or MI compared with BMS in patients with CCS. The observed treatment effect in the CCS population was similar to that observed in patients with ACS, representing most included patients. There is also robust evidence that DES, compared with BMS, decreases the risk of MI and TVR in patients with
Disclosures
The authors have no conflicts of interest to declare.
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This study was funded by institutional support from the Department of Cardiology at Bern University Hospital, Bern, Switzerland. There was no industry involvement in the design, analysis, or funding of this study.
Systematic Review Registration: PROSPERO CRD42017060520.