Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease: A systematic review and meta-analysis

Luca Testa, Pierfrancesco Agostoni, Paul Vermeersch, Giuseppe Biondi-Zoccai, William Van Gaal, Ravinay Bhindi, Emmanouil Brilakis, Roberto A. Latini, Maria Luisa Laudisa, Samuele Pizzocri, Stefania Lanotte, Nedy Brambilla, Adrian Banning, Francesco Bedogni

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Aims: Treatment of saphenous vein graft (SVG) disease is still a matter of debate given the uncertainty of the available conflicting data. Our aim was to assess, by means of a meta-analytic approach, the risk/benefit profile of drug eluting stents (DES) versus bare metal stents (BMS) in the treatment of SVG disease. Methods and results: A search of relevant studies in several databases was performed. The endpoints of interest such as: major adverse events (MAE) (the combination of overall death and non-fatal myocardial infarction [AMI]), target vessel revascularisation (TVR), and target lesion revascularisation (TLR) have been calculated in-hospital and at the longest follow-up. Single endpoints and the rate of stent thrombosis (ST) were also assessed. Three randomised controlled trials and 15 registry studies were appraised, totalling 3,294 patients. During hospitalisation, there was no difference in the risk of MAE, overall death, AMI and TVR. No data were available to calculate the TLR rate. At a mean follow-up of 19.8 months, no significant differences were found in the risk of MAE and AMI. BMS were associated with a trend towards a higher risk of overall death (OR 1.32 [1,00-1.74], p=0.05, number needed to treat [NNT]=55). DES showed superiority in terms of TVR (OR 1.86 [1.33-2.61], p=0.0003, NNT=16), and TLR (OR 1.77 [1.27-2.48], p<0.0001, NNT=25). According to pre-specified subgroup analyses, these effects seem less evident at the long-term follow-up. DES were not associated with an increased risk of ST. Conclusions: Use of DES in SVG substantially reduces both TVR and TLR. These data also demonstrate that using DES in SVG is safe and contradict previous reports of potential risks.

Original languageEnglish (US)
Pages (from-to)527-536
Number of pages10
JournalEuroIntervention
Volume6
Issue number4
StatePublished - Sep 2010

Fingerprint

Drug-Eluting Stents
Saphenous Vein
Stents
Meta-Analysis
Numbers Needed To Treat
Metals
Transplants
Thrombosis
Therapeutics
Uncertainty
Registries
Hospitalization
Randomized Controlled Trials
Myocardial Infarction
Databases

Keywords

  • Bare metal stent
  • Complex lesions
  • Drug eluting stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Testa, L., Agostoni, P., Vermeersch, P., Biondi-Zoccai, G., Van Gaal, W., Bhindi, R., ... Bedogni, F. (2010). Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease: A systematic review and meta-analysis. EuroIntervention, 6(4), 527-536.

Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease : A systematic review and meta-analysis. / Testa, Luca; Agostoni, Pierfrancesco; Vermeersch, Paul; Biondi-Zoccai, Giuseppe; Van Gaal, William; Bhindi, Ravinay; Brilakis, Emmanouil; Latini, Roberto A.; Laudisa, Maria Luisa; Pizzocri, Samuele; Lanotte, Stefania; Brambilla, Nedy; Banning, Adrian; Bedogni, Francesco.

In: EuroIntervention, Vol. 6, No. 4, 09.2010, p. 527-536.

Research output: Contribution to journalArticle

Testa, L, Agostoni, P, Vermeersch, P, Biondi-Zoccai, G, Van Gaal, W, Bhindi, R, Brilakis, E, Latini, RA, Laudisa, ML, Pizzocri, S, Lanotte, S, Brambilla, N, Banning, A & Bedogni, F 2010, 'Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease: A systematic review and meta-analysis', EuroIntervention, vol. 6, no. 4, pp. 527-536.
Testa L, Agostoni P, Vermeersch P, Biondi-Zoccai G, Van Gaal W, Bhindi R et al. Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease: A systematic review and meta-analysis. EuroIntervention. 2010 Sep;6(4):527-536.
Testa, Luca ; Agostoni, Pierfrancesco ; Vermeersch, Paul ; Biondi-Zoccai, Giuseppe ; Van Gaal, William ; Bhindi, Ravinay ; Brilakis, Emmanouil ; Latini, Roberto A. ; Laudisa, Maria Luisa ; Pizzocri, Samuele ; Lanotte, Stefania ; Brambilla, Nedy ; Banning, Adrian ; Bedogni, Francesco. / Drug eluting stents versus bare metal stents in the treatment of saphenous vein graft disease : A systematic review and meta-analysis. In: EuroIntervention. 2010 ; Vol. 6, No. 4. pp. 527-536.
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AU - Biondi-Zoccai, Giuseppe

AU - Van Gaal, William

AU - Bhindi, Ravinay

AU - Brilakis, Emmanouil

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AU - Laudisa, Maria Luisa

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