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Open Access Role of Second-Generation Drug-Eluting Stents and Bypass Grafting in Coronary Artery Disease: A Systematic Review and Meta-analysis

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Background: The safety and efficacy of coronary artery bypass grafting (CABG) and second-generation drug-eluting stents (DESs) in patients with coronary artery disease (CAD) remain controversial. Therefore we aimed to compare the outcomes of CAD patients treated with CABG and second-generation DESs.

Methods: We systematically searched the PubMed, Cochrane Library, Ovid, and Elsevier databases. Studies comparing second-generation DESs with CABG in CAD patients were included. RevMan 5.3 was used to extract and pool the data from the applicable studies.

Results: Six trials (N=6604 participants) were included in this meta-analysis. Among all of the CAD patients, second-generation DESs were associated with no differences in the risks of all-cause death [risk ratio (RR) 1.18, 95% confidence interval (CI) 0.98‐1.43, P=0.09], cardiovascular death (RR 1.14, 95% CI 0.81‐1.59, P=0.45), myocardial infarction (RR 1.22, 95% CI 0.98‐1.54, P=0.08), and stroke (RR 0.83, 95% CI 0.59‐1.17, P=0.29), but increased the risks of revascularization (RR 1.95, 95% CI 1.66‐2.30, P<0.001) and major adverse cardiac and cerebrovascular events (RR 1.72, 95% CI:1.31‐2.26, P<0.001) when compared with CABG.

Conclusions: In the treatment of CAD patients, second-generation DESs was not associated with increased risks of all-cause death, cardiovascular death, myocardial infarction, and stroke, but increased the risks of revascularization and major adverse cardiac and cerebrovascular events when compared with CABG.
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Keywords: coronary artery bypass grafting; coronary artery disease; everolimus-eluting stents; second-generation drug-eluting stents; zotarolimus-eluting stents

Document Type: Research Article

Publication date: February 1, 2017

This article was made available online on February 9, 2017 as a Fast Track article with title: "Role of Second-Generation Drug-Eluting Stents and Bypass Grafting in Coronary Artery Disease: A Systematic Review and Meta-analysis".

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  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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