Drug-eluting stents were associated with a higher risk of late acquired stent malapposition compared with bare-metal stents (OR 4.36; 95% CI 1.74-10.94), which associated with late stent thrombosis.
Meta-Analysis
Effect estimate: OR 4.36 (95% CI 1.74-10.94)
AIMS: Late stent malapposition (LSM) may be acquired (LASM) or persistent. LSM may play a role in patients who develop late stent thrombosis (ST). Our objective was to compare the risk of LASM in bare metal stents (BMS) with drug-eluting stents (DES) and to investigate the possible association of both acquired and persistent LSM with (very) late ST. METHODS AND RESULTS: We searched PubMed and relevant sources from January 2002 to December 2007. Inclusion criteria were: (a) intra-vascular ultrasonography (IVUS) at both post-stent implantation and follow-up; (b) 6-9-month-follow-up IVUS; (c) implantation of either BMS or the following DES: sirolimus, paclitaxel, everolimus, or zotarolimus; and (d) follow-up for LSM. Of 33 articles retrieved for detailed evaluation, 17 met the inclusion criteria. The risk of LASM in patients with DES was four times higher compared with BMS (OR = 4.36, CI 95% 1.74-10.94) in randomized clinical trials. The risk of (very) late ST in patients with LSM (five studies) was higher compared with those without LSM (OR = 6.51, CI 95% 1.34-34.91). CONCLUSION: In our meta-analysis, the risk of LASM is strongly increased after DES implantation compared with BMS. Furthermore, LSM seems to be associated with late and very late ST.
Hassan et al. (Wed,) conducted a meta-analysis in Late stent malapposition and late stent thrombosis. Drug-eluting stents (DES) vs. Bare metal stents (BMS) was evaluated on Late acquired stent malapposition (LASM) (OR 4.36, 95% CI 1.74-10.94). Drug-eluting stents were associated with a higher risk of late acquired stent malapposition compared with bare-metal stents (OR 4.36; 95% CI 1.74-10.94), which associated with late stent thrombosis.