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dc.contributor.author | Valgimigli, Marco |
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dc.contributor.author | Sabaté Tenas, Manuel |
dc.contributor.author | Kaiser, Cristoph |
dc.contributor.author | Brugaletta, Salvatore |
dc.contributor.author | Torre Hernández, José María de la |
dc.contributor.author | Galatius, Soeren |
dc.contributor.author | Cequier Fillat, Àngel R. |
dc.contributor.author | Eberli, Franz |
dc.contributor.author | De Belder, Adam |
dc.contributor.author | Serruys, Patrick W. |
dc.contributor.author | Ferrante, Giuseppe |
dc.date | 2015-06-16T17:12:12Z |
dc.date | 2015-06-16T17:12:12Z |
dc.date | 2014-11-04 |
dc.date | 2015-06-16T17:12:12Z |
dc.identifier | 2044-6055 |
dc.identifier | 649983 |
dc.identifier | 25378023 |
dc.identifier.uri | http://hdl.handle.net/2445/65899 |
dc.description | Objectives: To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents. Design: Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported. Data sources and study selection: Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients. Primary outcomes: The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death. Results: The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; P<0.001), and target vessel revascularisation (0.29, 0.20 to 0.41; P<0.001) at a median follow-up of 720 days. There was no significant difference in all cause death between groups (0.83, 0.65 to 1.06; P=0.14). Findings remained unchanged at multivariable regression after adjustment for the acuity of clinical syndrome (for instance, acute coronary syndrome v stable coronary artery disease), diabetes mellitus, female sex, use of glycoprotein IIb/IIIa inhibitors, and up to one year v longer duration treatment with dual antiplatelets. Conclusions: This meta-analysis offers evidence that compared with bare metal stents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis. |
dc.format | 17 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | BMJ Publishing Group |
dc.relation | Reproducció del document publicat a: http://dx.doi.org/10.1136/bmj.g6427 |
dc.relation | BMJ Open, 2014, vol. 349, p. 1-17 |
dc.relation | http://dx.doi.org/10.1136/bmj.g6427 |
dc.rights | cc-by (c) Valgimigli, Marco et al., 2014 |
dc.rights | http://creativecommons.org/licenses/by/3.0/es |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Malalties coronàries |
dc.subject | Artèries coronàries |
dc.subject | Infart de miocardi |
dc.subject | Pròtesis de Stent |
dc.subject | Coronary diseases |
dc.subject | Coronary arteries |
dc.subject | Myocardial infarction |
dc.subject | Stents (Surgery) |
dc.title | Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: patient level meta-analysis |
dc.type | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/publishedVersion |