与经皮冠状动脉介入术使用紫杉醇洗脱支架相关的支架血栓形成风险:荟萃分析

作     者：Bavry A.A. Kumbhani D.J. Helton T.J. Bhatt D.L. 吴波 

作者机构：Dr.Interventional Cardiol. C. Cleveland Clinic Foundation Dept. of Cardiovascular Medicine 9500 Euclid Avenue Cleveland OH 44195 United States 

出 版 物：《世界核心医学期刊文摘(心脏病学分册)》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第9期

页      面：61-62页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

摘      要：OBJECTIVES: This study investigated the risk of stent thrombosis associated with the use of paclitaxel-eluting stents(PES) compared to bare-metal stents(BMS). BACKGROUND: Clinical experience with coronary drug-eluting stents(DES) is relatively limited. There is concern that DES used for percutaneous coronary intervention may result in subsequent thrombosis. METHODS: We conducted a meta-analysis on eight trials(total of 13 study arms) in 3,817 patients with coronary artery disease who were randomized to either PES or BMS. RESULTS: As compared with BMS, PES do not increase the hazard for thrombosis up to 12 months(risk ratio[RR]=1.06, 95%confidence interval[CI] 0.55 to 2.04, p=0.86]). There was no evidence of heterogeneity among the studies(chi-square value for Q-statistic=5.90[10 degrees of freedom], p=0.82). Similar results were obtained when the analysis was restricted to trials with a polymeric stent platform(Treatment of de novo coronary disease using a single pAclitaXel elUting Stent[TAXUS] -I, -II, -IV, and -VI)(RR=1.01, 95%CI 0.40 to 2.53, p=0.99), trials with longer lesions(TAXUS-IV and -VI)(RR=0.62, 95%CI 0.2 to 1.91, p=0.41), and trials that used a higher dose of paclitaxel(ASian Paclitaxel-Eluting Stent Clinical trial[ASPECT], European evaLUaTion of paclitaxel Eluting Stents[ELUTES], and DELIVER-I)(RR=1.87, 95%CI 0.52 to 6.81, p=0.34). CONCLUSIONS: Current evidence suggests that standard dose PES do not increase the hazard of stent thrombosis compared to BMS.