Coronary Artery Disease
Definite stent thrombosis after drug-eluting stent implantation in coronary bifurcation lesions: A meta-analysis of 3,107 patients from 14 randomized trials
Yu Zhou MD,
Shengda Chen MS,
Lan Huang MD, PhD,
David Hildick-Smith MD,
Miroslaw Ferenc MD,
Richard J. Jabbour MD,
Lorenzo Azzalini MD, PhD, MSc,
Antonio Colombo MD,
Alaide Chieffo MD,
Xiaohui Zhao MD, PhD,
Yu Zhou MD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Search for more papers by this authorShengda Chen MS
State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, China
IBiTech, bioMMeda, Department of Electronics and Information Systems, iMinds Medical IT Department, Ghent University, De Pintelaan, Ghent, Belgium
Search for more papers by this authorLan Huang MD, PhD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Search for more papers by this authorDavid Hildick-Smith MD
Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom
Search for more papers by this authorMiroslaw Ferenc MD
The Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Suedring 15, Bad Krozingen, Germany
Search for more papers by this authorRichard J. Jabbour MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorLorenzo Azzalini MD, PhD, MSc
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorAntonio Colombo MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorCorresponding Author
Alaide Chieffo MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Correspondence Xiaohui Zhao, MD, PhD, 183 Xinqiao Street, ShapingBa District, Chongqing 400037, China. Email: [email protected] or Alaide Chieffo, MD, San Raffaele Hospital, Via Olgettina 60, 20121, Milan, Italy. Email: [email protected]Search for more papers by this authorCorresponding Author
Xiaohui Zhao MD, PhD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Correspondence Xiaohui Zhao, MD, PhD, 183 Xinqiao Street, ShapingBa District, Chongqing 400037, China. Email: [email protected] or Alaide Chieffo, MD, San Raffaele Hospital, Via Olgettina 60, 20121, Milan, Italy. Email: [email protected]Search for more papers by this authorYu Zhou MD,
Shengda Chen MS,
Lan Huang MD, PhD,
David Hildick-Smith MD,
Miroslaw Ferenc MD,
Richard J. Jabbour MD,
Lorenzo Azzalini MD, PhD, MSc,
Antonio Colombo MD,
Alaide Chieffo MD,
Xiaohui Zhao MD, PhD,
Yu Zhou MD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Search for more papers by this authorShengda Chen MS
State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, China
IBiTech, bioMMeda, Department of Electronics and Information Systems, iMinds Medical IT Department, Ghent University, De Pintelaan, Ghent, Belgium
Search for more papers by this authorLan Huang MD, PhD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Search for more papers by this authorDavid Hildick-Smith MD
Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom
Search for more papers by this authorMiroslaw Ferenc MD
The Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Suedring 15, Bad Krozingen, Germany
Search for more papers by this authorRichard J. Jabbour MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorLorenzo Azzalini MD, PhD, MSc
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorAntonio Colombo MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Search for more papers by this authorCorresponding Author
Alaide Chieffo MD
Cardiology Department, San Raffaele Hospital, Milan, Italy
Correspondence Xiaohui Zhao, MD, PhD, 183 Xinqiao Street, ShapingBa District, Chongqing 400037, China. Email: [email protected] or Alaide Chieffo, MD, San Raffaele Hospital, Via Olgettina 60, 20121, Milan, Italy. Email: [email protected]Search for more papers by this authorCorresponding Author
Xiaohui Zhao MD, PhD
Institution of Cardiovascular Research, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Correspondence Xiaohui Zhao, MD, PhD, 183 Xinqiao Street, ShapingBa District, Chongqing 400037, China. Email: [email protected] or Alaide Chieffo, MD, San Raffaele Hospital, Via Olgettina 60, 20121, Milan, Italy. Email: [email protected]Search for more papers by this authorFunding information: National Natural Science Foundation of China, Grant/Award Numbers: 81070168, 81670428, 11402041, and 81370213; Third Military Medical University, Chongqing, China, Grant/Award Number: 2014YLC02
Journal Subject Codes: Catheter-Based Coronary Interventions: Stents
Abstract
Background
Bifurcation percutaneous coronary intervention (PCI) is a challenging procedure, but there are currently inadequate data about definite stent thrombosis (ST) rates of single-stent versus double-stent strategies (SS and DS, respectively).
Methods and results
Randomized clinical trials (RCTs) comparing SS and DS strategies were searched through PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Fourteen RCTs involving 3,107 patients were analyzed. Owing to the high crossover rate (16.49%), both intention-to-treat (ITT) and as-treated (AT) analyses were performed. In the ITT population, there was a significantly lower rate of early definite ST in the SS group (0.26%; DS group 1.14%; P = 0.021). Similarly, in the AT population, there was a significantly lower rate of early definite ST in the SS group (0.23%, DS group 1.07%; P = 0.042). True bifurcation subgroup analysis also showed a significantly lower early definite ST in the SS group (OR = 0.36, 95% CI = 0.15–0.86, P = 0.042) in the ITT population. There was no significant difference of overall, acute, subacute, and late definite ST between the 2 groups.
Conclusions
Early definite ST is reduced when a SS strategy is used in bifurcation lesions.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interest.
Supporting Information
Additional Supporting Information may be found online in the supporting information tab for this article.
| Filename | Description |
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| ccd27443-sup-0001-suppinfo01.tif24.3 MB | Supplementary Figure 1 |
| ccd27443-sup-0002-suppinfo02.docx29.3 KB | Supplementary Materials 1 |
| ccd27443-sup-0003-suppinfo03.docx12.6 KB | Supplementary Materials 2 |
| ccd27443-sup-0004-suppinfo04.docx18.3 KB | Supplementary Materials 3 |
| ccd27443-sup-0005-suppinfo05.docx2.2 MB | Supplementary Materials 4 |
| ccd27443-sup-0006-suppinfo06.docx1.1 MB | Supplementary Materials 5 |
| ccd27443-sup-0007-suppinfo07.docx2.3 MB | Supplementary Materials 6 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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