比较药物涂层球囊与普通球囊血管成形术治疗支架内冠状动脉再狭窄的 Meta 分析。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Safia Shaikh MD , Mohammad Hamza MD , Prakash Upreti MD , Mohammad Akkawi MD , Kripa Rajak MD , Mobeen Zaka Haider MD , Nomesh Kumar MD , Mustafa Turkmani MD , Fadi Kathawa MD , Salman Abdul Basit MD , Yasemin Bahar MD , Sadaf Fakhra MD , Yasar Sattar MD , M. Chadi Alraies MD
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引用次数: 0

摘要

背景:尽管出现了较新的支架,但支架内再狭窄一直是一个难以克服的挑战。试验证明药物涂层球囊(DCB)优于普通球囊血管成形术(POBA)。最近的一项AGENT IDE试验强调了更全面了解的必要性,因此我们进行了一项荟萃分析,旨在阐明它们各自的临床结果:两名研究人员(SS 和 MH)使用 MEDLINE(EMBASE 和 PubMed),采用 PRISMA 系统检索策略进行了文献检索,直至 2023 年 11 月 1 日。使用 CRAN-R 软件进行统计分析。使用 Cochrane 偏倚风险工具进行了质量评估(补充表 5):我们纳入了 6 项研究,共 1171 名患者。我们的分析表明,多种结果的几率下降,其中包括 TVR(OR 0.33,CI 0.19-0.57)、TVF(OR 0.30,CI 0.09-0.99)、TLR(OR 0.22,CI 0.10-0.46)、再狭窄(OR 0.1343,CI 0.06-0.27)和 MACE(OR 0.2,CI 0.12-0.37),这些结果具有统计学意义。虽然心肌梗死和全因死亡的几率有所下降,其中全因死亡的几率为0.8(95% CI:0.363-2.09),心肌梗死的几率为0.6(95% CI:0.0349-1.07),但下降幅度未达到统计学意义:我们通过仔细研究六项研究结果进行了分析,结果表明 DCB 比 POBA 更受青睐。结论:我们通过仔细研究六项临床试验进行的分析表明,DCB 比 POBA 更受青睐。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Meta-Analysis Comparing Drug-Coated Balloon Versus Plain Old Balloon Angioplasty for In-Stent Restenosis of Coronary Arteries

Meta-Analysis Comparing Drug-Coated Balloon Versus Plain Old Balloon Angioplasty for In-Stent Restenosis of Coronary Arteries

Despite the advent of newer stents, in-stent restenosis has been a persistent and formidable challenge. Trials have demonstrated the superiority of drug-coated balloons over plain old balloon angioplasty. A recent AGENT IDE PRESTO (Prevention of REStenosis with Tranilast and its Outcomes) trial highlighted the need for a more comprehensive understanding; therefore, we conducted a meta-analysis to elucidate their respective clinical outcomes. A literature search was conducted by 2 investigators (SS and MH) using MEDLINE (EMBASE and PubMed) using a systematic search strategy by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) until November 1, 2023. CRAN-R software was used for statistical analysis. The quality assessment was performed using the Cochrane Risk of Bias tool (Supplementary Table 5). We included 6 studies with a total of 1,171 patients. Our analysis showed decreased odds of multiple outcomes with statistically significant results, including target vessel revascularization (odds ratio [OR] 0.33, confidence interval [CI] 0.19 to 0.57), target vessel failure (OR 0.30, CI 0.09 to 0.99), target lesion revascularization (OR 0.22, CI 0.10 to 0.46), restenosis (OR 0.1343, CI 0.06 to 0.27), and major adverse cardiac events (OR 0.2 CI 0.12 to 0.37). Although myocardial infraction and all-cause mortality showed decreased odds with all-cause mortality at 0.8 (95% CI 0.363 to 2.09), and myocardial infarction at 0.6 (95% CI 0.0349 to 1.07), the reductions did not reach statistical significance. Our analysis by scrutinizing 6 randomized controlled trials favored drug-coated balloons over plain old balloon angioplasty. However, extensive research for deeper understanding cannot be overemphasized.

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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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