Original scientific paper

https://doi.org/10.57140/mj.55.2.4

The efficacy and safety of the intracoronary stents at patients with acute stemi: a meta-analysis and systematic review

Marko Mornar Jelavić orcid.org/0000-0002-9135-1820 ; Polyclinic Affidea Sveti Rok, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Dražen Zekanović ; Department of Cardiology, Internal Medicine Clinic, Zadar General Hospital, Zadar, Croatia; School of Medicine, University of Split, Split, Croatia
Hrvoje Pintarić ; School of Dental Medicine, University of Zagreb, Zagreb, Croatia; Polyclinic AVIVA, Zagreb, Croatia; Department of Traumatology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Augustin Pintarić ; School of Medicine, University of Zagreb, Zagreb, Croatia
Zdravko Babić ; School of Medicine, University of Zagreb, Zagreb, Croatia; Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; Department of Cardiology, Internal Medicine Clinic, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia

Abstract

Introduction: This meta-analysis investigates and reevaluates the efficacy and safety of various
intracoronary stents after acute ST-elevation myocardial infarction (STEMI).
Methods: PubMed/ScienceDirect databases were systematically searched for Randomized Controlled
Trials (RCTs) w2ith outcomes after acute STEMI in relation to stent type. During follow-up, the efficacy
outcomes were target lesion revascularization (TLR) and target vessel revascularization (TVR), while the
safety outcomes were overall death, cardiac death, myocardial infarction, total in-stent thrombosis (IST)
and major adverse cardiovascular events/target vessel failure (MACE/TVF) (the composite of
overall/cardiac death, myocardial infarction, TLR and TVR). Stents were classified as bare-metal stent
(BMS), drug-eluting stent of the first (DES1st) and second-generation (DES2nd), and biodegradable polymer
DES (BP-DES).
Results: We included 31 RCTs, with 17,010 participants (74.6% males), with an average age of 61.2
years. During the average 35-month follow-up, DES are preferred over BMS in reducing the risk of TLR
(odds ratio (OR) = 0.47, confidence interval (CI) [0.41-0.54]), TVR (OR = 0.54, CI [0.47-0.61]), overall
death (OR = 0.85, CI [0.74-0.99]) and MACE/TVF (OR = 0.61, CI [0.55-0.68]); DES2nd are preferred over
DES1st in reducing the risk of myocardial infarction (OR = 0.61, CI [0.39-0.96]), IST (OR = 0.41, CI [0.22-
0.73]) and MACE/TVF (OR = 0.70, CI [0.54-0.90]); and, BP-DES are preferred over DES2nd in reducing
the risk of TLR (OR = 0.55, CI [0.35-0.86]) and IST (OR = 0.56, CI [0.33-0.96]) (for all P<0.05).
Conclusion: After acute STEMI, DES are superior to BMS in efficacy and safety, DES2nd to DES1st in
safety, and BP-DES to DES2nd in efficacy and safety.

Keywords

stents; acute ST-elevation myocardial infarction; outcomes

Hrčak ID:

332550

URI

https://hrcak.srce.hr/332550

Publication date:

20.6.2025.

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