Imperial College London
Portrait Picture

DrJamesHoward

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Cardiology (Cardiac MR and AI)
 
 
 
//

Contact

 

james.howard1 Website CV

 
 
//

Location

 

Block B Hammersmith HospitalHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Ahmad:2021:eurheartj/ehab280,
author = {Ahmad, Y and Howard, J},
doi = {eurheartj/ehab280},
journal = {European Heart Journal},
pages = {2643--2654},
title = {Long-term follow-up after ultrathin versus conventional second-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials},
url = {http://dx.doi.org/10.1093/eurheartj/ehab280},
volume = {42},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsContemporary 2nd-generation thin-strut drug-eluting stents (DES) are considered standard of care for revascularization of patients undergoing percutaneous coronary intervention. A previous meta-analysis of 10 randomized controlled trials (RCTs) with 11 658 patients demonstrated a 16% reduction in the 1-year risk of target lesion failure (TLF) with ultrathin-strut DES compared with conventional 2nd-generation thin-strut DES. Whether this benefit is sustained longer term is not known, and newer trial data may inform these relative outcomes. We therefore sought to perform an updated systematic review and meta-analysis of RCTs comparing clinical outcomes with ultrathin-strut DES (≤70 µm strut thickness) with conventional 2nd-generation thin-strut DES.Methods and resultsWe performed a random-effects meta-analysis of all RCTs comparing ultrathin-strut DES to conventional 2nd-generation thin-strut DES. The pre-specified primary endpoint was long-term TLF, a composite of cardiac death, myocardial infarction (MI), or clinically driven target lesion revascularization (CD-TLR). Secondary endpoints included the components of TLF, stent thrombosis (ST), and all-cause death. There were 16 eligible trials in which 20 701 patients were randomized. The weighted mean follow-up duration was 2.5 years. Ultrathin-strut DES were associated with a 15% reduction in long-term TLF compared with conventional 2nd-generation thin-strut DES [relative risk (RR) 0.85, 95% confidence interval (CI) 0.76–0.96, P = 0.008] driven by a 25% reduction in CD-TLR (RR 0.75, 95% CI 0.62–0.92, P = 0.005). There were no significant differences between stent types in the risks of MI, ST, cardiac death, or all-cause mortality.ConclusionsAt a mean follow-up of 2.5 years, ultrathin-strut DES reduced the risk of TLF, driven by less CD-TLR compared with conventional 2nd-generation thin-strut DES, with similar risks of MI, ST, cardiac death, and
AU  - Ahmad,Y
AU  - Howard,J
DO  - eurheartj/ehab280
EP  - 2654
PY  - 2021///
SN  - 0195-668X
SP  - 2643
TI  - Long-term follow-up after ultrathin versus conventional second-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials
T2  - European Heart Journal
UR  - http://dx.doi.org/10.1093/eurheartj/ehab280
UR  - https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab280/6276781
UR  - http://hdl.handle.net/10044/1/89406
VL  - 42
ER  -
Download