Details

Autor(en) / Beteiligte

• D'Ascenzo, Fabrizio
• Iannaccone, Mario
• Saint-Hilary, Gaelle
• Bertaina, Maurizio
• Schulz-Schüpke, Stefanie
• Wahn Lee, Cheol
• Chieffo, Alaide
• Helft, Gerard
• Gili, Sebastiano
• Barbero, Umberto
• Biondi Zoccai, Giuseppe
• Moretti, Claudio
• Ugo, Fabrizio
• D'Amico, Maurizio
• Garbo, Roberto
• Stone, Gregg
• Rettegno, Sara
• Omedè, Pierluigi
• Conrotto, Federico
• Templin, Christian
• Colombo, Antonio
• Park, Seung-Jung
• Kastrati, Adnan
• Hildick-Smith, David
• Gasparini, Mauro
• Gaita, Fiorenzo

Titel

Impact of design of coronary stents and length of dual antiplatelet therapies on ischaemic and bleeding events: a network meta-analysis of 64 randomized controlled trials and 102 735 patients

Ist Teil von

• European heart journal, 2017-11, Vol.38 (42), p.3160-3172

Ort / Verlag

England: Oxford University Press (OUP)

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• The differential impact on ischaemic and bleeding events of the type of drug-eluting stent [durable polymer stents [DES] vs. biodegradable polymer stents vs. bioresorbable scaffolds (BRS)] and length of dual antiplatelet therapy (DAPT) remains to be defined. Randomized controlled trials comparing different types of DES and/or DAPT durations were selected. The primary endpoint was Major Adverse Cardiovascular Events (MACE) [a composite of death, myocardial infarction (MI), and target vessel revascularization]. Definite stent thrombosis (ST) and single components of MACE were secondary endpoints. The arms of interest were: BRS with 12 months of DAPT (12mDAPT), biodegradable polymer stent with 12mDAPT, durable polymer stent [everolimus-eluting (EES), zotarolimus-eluting (ZES)] with 12mDAPT, EES/ZES with <12 months of DAPT, and EES/ZES with >12 months of DAPT (DAPT > 12 m). Sixty-four studies with 150 arms and 102 735 patients were included. After a median follow-up of 20 months, MACE rates were similar in the different arms of interest. EES/ZES with DAPT > 12 m reported a lower incidence of MI than the other groups, while BRS showed a higher rate of ST when compared to EES/ZES, irrespective of DAPT length. A higher risk of major bleedings was observed for DAPT > 12 m as compared to shorter DAPT. Durable and biodegradable polymer stents along with BRS report a similar rate of MACE irrespective of DAPT length. Fewer MI are observed with EES/ZES with DAPT > 12 m, while a higher rate of ST is reported for BRS when compared to EES/ZES, independently from DAPT length. Stent type may partially affect the outcome together with DAPT length.