Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile o...
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| Veröffentlicht in: | International journal of cardiology 2024-10, Vol.412, p.132269, Article 132269 |
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| container_title | International journal of cardiology |
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| creator | Kumar, Manoj Kumar, Nomesh Upreti, Prakash Zaka Haider, Mobeen Naser, Abdallah Basit, Salman Abdul Turkmani, Mustafa Rajak, Kripa Bahar, Yasemin Hamza, Mohammad Sattar, Yasar Alraies, M. Chadi |
| description | In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.
Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).
Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR: 0.45, 95% CI: 0.31–0.64, p-value |
| doi_str_mv | 10.1016/j.ijcard.2024.132269 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3069171852</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S016752732400891X</els_id><sourcerecordid>3069171852</sourcerecordid><originalsourceid>FETCH-LOGICAL-c311t-98b7f123f861025a179efed6510902bd644b50d4739deaf17c5c92d476a6cbae3</originalsourceid><addsrcrecordid>eNp9kc-O1DAMxiMEYoeFN0AoRy4tSZo2DQekYfgrLUJalnOUJu6QUdoMSbqr4UF4XjLqwpHTZ1s_27I_hJ5TUlNCu1eH2h2MjrZmhPGaNox18gHa0F7wioqWP0SbgomqZaK5QE9SOhBCuJT9Y3TR9H1POBUb9PtdXPYV-CW7eY9Thjnj21Tjt9r7EGas570LR69TPmE346POriAJ37n8oxSqtSPCWUNy6TXe4m-nkk2FNPgabh3clSkWf4Gsq-2s_algOIz4ulTD5H6Bxbsw5xi8L-FNdNqnp-jRWASe3esl-v7h_c3uU3X19ePn3faqMg2luZL9IEbKmrHvKGGtpkLCCLZrKZGEDbbjfGiJ5aKRFvRIhWmNZCXvdGcGDc0lernOPcbwcylXqMklA97rGcKSVEM6SQXtW1ZQvqImhpQijOoY3aTjSVGizo6og1odUWdH1OpIaXtxv2EZJrD_mv5aUIA3KwDlzvKtqJIpPzZgXQSTlQ3u_xv-AOOMoPY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3069171852</pqid></control><display><type>article</type><title>Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><source>Elsevier ScienceDirect Journals</source><creator>Kumar, Manoj ; Kumar, Nomesh ; Upreti, Prakash ; Zaka Haider, Mobeen ; Naser, Abdallah ; Basit, Salman Abdul ; Turkmani, Mustafa ; Rajak, Kripa ; Bahar, Yasemin ; Hamza, Mohammad ; Sattar, Yasar ; Alraies, M. Chadi</creator><creatorcontrib>Kumar, Manoj ; Kumar, Nomesh ; Upreti, Prakash ; Zaka Haider, Mobeen ; Naser, Abdallah ; Basit, Salman Abdul ; Turkmani, Mustafa ; Rajak, Kripa ; Bahar, Yasemin ; Hamza, Mohammad ; Sattar, Yasar ; Alraies, M. Chadi</creatorcontrib><description>In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.
Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).
Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR: 0.45, 95% CI: 0.31–0.64, p-value <0.0001), and target lesion revascularization (TLR) (RR: 0.59, 95%CI: 0.44–0.78, p-value 0.0002) compared to BA. However, all-cause mortality, cardiovascular mortality, incidence of myocardial infarction (MI), and target lesion thrombosis were not different between the two intervention arms.
DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR. No difference in mortality, risk of MI, or target lesion thrombosis was observed between the two interventions.
[Display omitted]
•Drug-eluting stent (DES) for treatment of in-stent restenosis has reduced the risk for target lesion revascularization (TLR) and target vessel revascularization (TVR) compared to balloon angioplasty (BA).•No difference in mortality, risk of myocardial infarction, or target lesion thrombosis was observed between the two interventions.•DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR.</description><identifier>ISSN: 0167-5273</identifier><identifier>ISSN: 1874-1754</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2024.132269</identifier><identifier>PMID: 38880417</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><ispartof>International journal of cardiology, 2024-10, Vol.412, p.132269, Article 132269</ispartof><rights>2023</rights><rights>Copyright © 2024. Published by Elsevier B.V.</rights><rights>Copyright © 2023. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c311t-98b7f123f861025a179efed6510902bd644b50d4739deaf17c5c92d476a6cbae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S016752732400891X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38880417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Manoj</creatorcontrib><creatorcontrib>Kumar, Nomesh</creatorcontrib><creatorcontrib>Upreti, Prakash</creatorcontrib><creatorcontrib>Zaka Haider, Mobeen</creatorcontrib><creatorcontrib>Naser, Abdallah</creatorcontrib><creatorcontrib>Basit, Salman Abdul</creatorcontrib><creatorcontrib>Turkmani, Mustafa</creatorcontrib><creatorcontrib>Rajak, Kripa</creatorcontrib><creatorcontrib>Bahar, Yasemin</creatorcontrib><creatorcontrib>Hamza, Mohammad</creatorcontrib><creatorcontrib>Sattar, Yasar</creatorcontrib><creatorcontrib>Alraies, M. Chadi</creatorcontrib><title>Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.
Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).
Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR: 0.45, 95% CI: 0.31–0.64, p-value <0.0001), and target lesion revascularization (TLR) (RR: 0.59, 95%CI: 0.44–0.78, p-value 0.0002) compared to BA. However, all-cause mortality, cardiovascular mortality, incidence of myocardial infarction (MI), and target lesion thrombosis were not different between the two intervention arms.
DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR. No difference in mortality, risk of MI, or target lesion thrombosis was observed between the two interventions.
[Display omitted]
•Drug-eluting stent (DES) for treatment of in-stent restenosis has reduced the risk for target lesion revascularization (TLR) and target vessel revascularization (TVR) compared to balloon angioplasty (BA).•No difference in mortality, risk of myocardial infarction, or target lesion thrombosis was observed between the two interventions.•DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR.</description><issn>0167-5273</issn><issn>1874-1754</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc-O1DAMxiMEYoeFN0AoRy4tSZo2DQekYfgrLUJalnOUJu6QUdoMSbqr4UF4XjLqwpHTZ1s_27I_hJ5TUlNCu1eH2h2MjrZmhPGaNox18gHa0F7wioqWP0SbgomqZaK5QE9SOhBCuJT9Y3TR9H1POBUb9PtdXPYV-CW7eY9Thjnj21Tjt9r7EGas570LR69TPmE346POriAJ37n8oxSqtSPCWUNy6TXe4m-nkk2FNPgabh3clSkWf4Gsq-2s_algOIz4ulTD5H6Bxbsw5xi8L-FNdNqnp-jRWASe3esl-v7h_c3uU3X19ePn3faqMg2luZL9IEbKmrHvKGGtpkLCCLZrKZGEDbbjfGiJ5aKRFvRIhWmNZCXvdGcGDc0lernOPcbwcylXqMklA97rGcKSVEM6SQXtW1ZQvqImhpQijOoY3aTjSVGizo6og1odUWdH1OpIaXtxv2EZJrD_mv5aUIA3KwDlzvKtqJIpPzZgXQSTlQ3u_xv-AOOMoPY</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Kumar, Manoj</creator><creator>Kumar, Nomesh</creator><creator>Upreti, Prakash</creator><creator>Zaka Haider, Mobeen</creator><creator>Naser, Abdallah</creator><creator>Basit, Salman Abdul</creator><creator>Turkmani, Mustafa</creator><creator>Rajak, Kripa</creator><creator>Bahar, Yasemin</creator><creator>Hamza, Mohammad</creator><creator>Sattar, Yasar</creator><creator>Alraies, M. Chadi</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241001</creationdate><title>Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</title><author>Kumar, Manoj ; Kumar, Nomesh ; Upreti, Prakash ; Zaka Haider, Mobeen ; Naser, Abdallah ; Basit, Salman Abdul ; Turkmani, Mustafa ; Rajak, Kripa ; Bahar, Yasemin ; Hamza, Mohammad ; Sattar, Yasar ; Alraies, M. Chadi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-98b7f123f861025a179efed6510902bd644b50d4739deaf17c5c92d476a6cbae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Manoj</creatorcontrib><creatorcontrib>Kumar, Nomesh</creatorcontrib><creatorcontrib>Upreti, Prakash</creatorcontrib><creatorcontrib>Zaka Haider, Mobeen</creatorcontrib><creatorcontrib>Naser, Abdallah</creatorcontrib><creatorcontrib>Basit, Salman Abdul</creatorcontrib><creatorcontrib>Turkmani, Mustafa</creatorcontrib><creatorcontrib>Rajak, Kripa</creatorcontrib><creatorcontrib>Bahar, Yasemin</creatorcontrib><creatorcontrib>Hamza, Mohammad</creatorcontrib><creatorcontrib>Sattar, Yasar</creatorcontrib><creatorcontrib>Alraies, M. Chadi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Manoj</au><au>Kumar, Nomesh</au><au>Upreti, Prakash</au><au>Zaka Haider, Mobeen</au><au>Naser, Abdallah</au><au>Basit, Salman Abdul</au><au>Turkmani, Mustafa</au><au>Rajak, Kripa</au><au>Bahar, Yasemin</au><au>Hamza, Mohammad</au><au>Sattar, Yasar</au><au>Alraies, M. Chadi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>412</volume><spage>132269</spage><pages>132269-</pages><artnum>132269</artnum><issn>0167-5273</issn><issn>1874-1754</issn><eissn>1874-1754</eissn><abstract>In-stent restenosis (ISR) is seen in up to 20% of cases and is the primary cause of percutaneous coronary intervention (PCI) failure. With the use of re-stenting with a drug-eluting stent (DES), plain old balloon angioplasty (BA) use is decreasing. We aim to compare the efficacy and safety profile of DES over BA in the management of ISR.
Electronic databases were searched to identify all randomized controlled trials (RCTs) comparing DES to BA for coronary ISR. The mantel-Haenszel method with a random effects model was used to calculate pooled risk ratios (RR).
Four trials comprising 912 patients (543 in DES and 369 in the BA group) were included in the final study. The mean follow-up was 45 months. DES was found to be superior with a lower requirement of target vessel revascularization (TVR) (RR: 0.45, 95% CI: 0.31–0.64, p-value <0.0001), and target lesion revascularization (TLR) (RR: 0.59, 95%CI: 0.44–0.78, p-value 0.0002) compared to BA. However, all-cause mortality, cardiovascular mortality, incidence of myocardial infarction (MI), and target lesion thrombosis were not different between the two intervention arms.
DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR. No difference in mortality, risk of MI, or target lesion thrombosis was observed between the two interventions.
[Display omitted]
•Drug-eluting stent (DES) for treatment of in-stent restenosis has reduced the risk for target lesion revascularization (TLR) and target vessel revascularization (TVR) compared to balloon angioplasty (BA).•No difference in mortality, risk of myocardial infarction, or target lesion thrombosis was observed between the two interventions.•DES was found to be superior to BA for the management of coronary ISR with a reduction in the risk of TLR and TVR.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38880417</pmid><doi>10.1016/j.ijcard.2024.132269</doi></addata></record> |
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| title | Drug-eluting stent vs. Balloon angioplasty in patients with in-stent restenosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
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