Definite stent thrombosis after drug-eluting stent implantation in coronary bifurcation lesions: A meta-analysis of 3,107 patients from 14 randomized trials
Definite stent thrombosis after drug-eluting stent implantation in coronary bifurcation lesions: A meta-analysis of 3,107 patients from 14 randomized trials
复制标题
冠状动脉分叉病变中药物洗脱支架植入后明确的支架血栓形成：对来自 14 项随机试验的 3,107 名患者进行的荟萃分析。
DOI：
10.1002/ccd.27443
复制
发表时间：
2018-10-01
影响因子：
2.3
通讯作者：
Zhao, Xiaohui
中科院分区：
文献类型：
--
作者：
Zhou, Yu;Chen, Shengda;Zhao, Xiaohui
背景分叉型经皮冠状动脉介入治疗 (PCI) 是一项具有挑战性的手术，但目前关于单支架策略与双支架策略（分别为 SS 和 DS）的明确支架血栓 (ST) 发生率的数据不足。方法和结果结论通过 PubMed、Embase 和 Cochrane 对照试验中心注册库检索了比较 SS 和 DS 策略的随机临床试验 (RCT)。对涉及 3,107 名患者的 14 项随机对照试验进行了分析。由于交叉率较高（16.49%），因此同时进行了意向治疗（ITT）和治疗后（AT）分析。在ITT人群中，SS组早期明确ST的发生率显着较低（0.26%；DS组1.14%；P=0.021）。同样，在 AT 人群中，SS 组早期明确 ST 的发生率显着较低（0.23%，DS 组 1.07%；P=0.042）。真分叉亚组分析还显示，ITT 人群中 SS 组的早期明确 ST 显着较低（OR=0.36，95% CI=0.15-0.86，P=0.042）。两组间总体、急性、亚急性和晚期明确ST无显着差异。当分叉病变采用SS策略时，早期明确ST会减少。
BackgroundBifurcation percutaneous coronary intervention (PCI) is a challenging procedure, but there are currently inadequate data about definite stent thrombosis (ST) rates of single-stent versus double-stent strategies (SS and DS, respectively).Methods and resultsConclusionsRandomized clinical trials (RCTs) comparing SS and DS strategies were searched through PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Fourteen RCTs involving 3,107 patients were analyzed. Owing to the high crossover rate (16.49%), both intention-to-treat (ITT) and as-treated (AT) analyses were performed. In the ITT population, there was a significantly lower rate of early definite ST in the SS group (0.26%; DS group 1.14%; P=0.021). Similarly, in the AT population, there was a significantly lower rate of early definite ST in the SS group (0.23%, DS group 1.07%; P=0.042). True bifurcation subgroup analysis also showed a significantly lower early definite ST in the SS group (OR=0.36, 95% CI=0.15-0.86, P=0.042) in the ITT population. There was no significant difference of overall, acute, subacute, and late definite ST between the 2 groups.Early definite ST is reduced when a SS strategy is used in bifurcation lesions.