Key result
Direct stenting significantly reduced short-term major adverse cardiac events compared to conventional stenting in patients with acute coronary syndrome (5.00% vs 8.08%; OR 0.61; 95% CI 0.46-0.80; P=0.0004).
Why the study?
Does direct stenting reduce short-term MACEs compared to conventional stenting in patients with acute coronary syndrome?
Meta-Analysis (n=8,998)
Does direct stenting reduce short-term MACEs compared to conventional stenting in patients with acute coronary syndrome?
Odds Ratio: 0.61 (95% CI 0.46–0.8)
Absolute Event Rate: 5% vs 8.08%
p-value: p=.0004
Direct stenting in selected patients with ACS is safe and significantly reduces short-term MACEs, 1-year mortality, and no-reflow phenomenon compared to conventional stenting.
Supports direct stenting in ACS to cut short-term MACE; reinforces Level 1 meta-analytic evidence for optimized PCI.
Our aim was to compare direct stenting (DS) with conventional stenting (CS) in patients with acute coronary syndrome (ACS). We searched PubMed, EMBASE, and ISI web of science for eligible studies. Primary end point was major adverse cardiac events (MACEs) in short term. Secondary end points were 1-year mortality and after-procedural no-reflow phenomenon. Twelve trials in 8998 patients were included. The odds ratios (ORs) were pooled using the Mantel-Haenszel fixed effect model. Short-term MACEs were significantly reduced in the DS arm in contrast to the CS (5.00% vs 8.08%, DS vs CS, respectively, OR [95% confidence interval] = 0.61 [0.46-0.80], P = .0004). One-year mortality and after-procedural no-reflow phenomenon were significantly lower in the DS group. No heterogeneity was observed through I(2) test (Phet = .81, .89, and .77 for each end point, respectively). This meta-analysis demonstrated that in selected patients with ACS, DS is not only safe and feasible but also reduces short-term and 1-year mortality as well as the occurrence of after-procedural no-reflow phenomenon.
No takes yet. Share an insight, caveat, or question.
Li et al. (2015) conducted a meta-analysis in acute coronary syndrome (ACS) (n=8,998). Direct stenting (DS) vs. Conventional stenting (CS) was evaluated on major adverse cardiac events (MACEs) in short term (OR 0.61, 95% CI 0.46-0.80, p=.0004). Direct stenting significantly reduced short-term major adverse cardiac events compared to conventional stenting in patients with acute coronary syndrome (5.00% vs 8.08%; OR 0.61; 95% CI 0.46-0.80; P=0.0004).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: