Does the use of paclitaxel or rapamycin-eluting stent decrease further need for coronary-artery bypass grafting when compared with bare-metal stent?

Sao Paulo Med J. 2007 Jul 5;125(4):242-5. doi: 10.1590/s1516-31802007000400010.

Abstract

Context and objective: The safety and efficacy of drug-eluting stents reduce the need for surgical revascularization. The objective of the present study was to investigate whether paclitaxel or rapamycin-eluting stent are effective in avoiding the need for coronary-artery bypass grafting.

Methods: This was a systematic review of the literature using the methodology of the Cochrane Collaboration. The type of study considered was controlled randomized trials; the type of intervention was drug-eluting or bare-metal stents; and the main outcome investigated was coronary-artery bypass grafting.

Results: The ten studies included in this systematic review did not show any statistically significant difference between the drug-eluting stents and the bare-metal stents with regard to the outcome of coronary-artery bypass grafting (confidence interval: 0.31 to 1.42).

Conclusion: The surgical revascularization rate was not reduced by the use of drug-eluting stents.

CONTEXTO E OBJETIVO:: A segurança e eficácia dos stents recobertos com drogas reduz a necessidade da cirurgia de revascularização cardíaca. O objetivo foi verificar se os stents recobertos com paclitaxel ou rapamicina são efetivos para evitar a necessidade de revascularização cirúrgica das coronárias.

MÉTODOS:: Revisão sistemática da literatura usando a metodologia do Centro Cochrane. Tipos de estudos: estudos clínicos randomizados; tipo de intervenção: stents recobertos com drogas ou stents convencionais; desfecho principal: cirurgia de revascularização cardíaca.

RESULTADOS:: Os 10 estudos incluídos nesta revisão sistemática não mostram diferença estatisticamente significante entre os stents recobertos com drogas e os stents convencionais no desfecho principal, com intervalo de confiança de 0.31, 1.42.

CONCLUSÃO:: A taxa de revascularização cardíaca não é reduzida pelo uso de stents recobertos com drogas.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Coronary Artery Bypass*
  • Coronary Restenosis / prevention & control*
  • Cytostatic Agents / administration & dosage*
  • Drug-Eluting Stents
  • Humans
  • Paclitaxel / administration & dosage*
  • Randomized Controlled Trials as Topic
  • Sirolimus / administration & dosage*
  • Stents*
  • Treatment Outcome

Substances

  • Cytostatic Agents
  • Paclitaxel
  • Sirolimus