Zhang Qun, Huan Hengshan, Han Yu, Liu Han, Sun Shukun, Wang Bailu, Wei Shujian
Department of Emergency and Chest Pain Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Clinical Research Center for Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Clin Med Insights Cardiol. 2022 Aug 13;16:11795468221116842. doi: 10.1177/11795468221116842. eCollection 2022.
Stent placement remains a challenge for coronary bifurcation lesions. While both simple and complex stenting strategies are available, it is unclear which one results in better clinical outcomes. This meta-analysis aims to explore the long-term prognosis following treatment with the 2 stenting strategies.
Randomized controlled trials found from searches of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were included in this meta-analysis. The complex stent placement strategy was identified as the control group, and the simple stent placement strategy was identified as the experimental group. Data were synthesized with a random effects model. The quality of the randomized controlled trials was assessed by Jadad scale scores. The clinical endpoints at 6 months, 1 year, and 5 years were analyzed.
A total of 11 randomized controlled trials met the inclusion criteria. A total of 2494 patients were included in this meta-analysis. The odds ratio [OR] of the major adverse cardiac events (MACEs) at 6 months was 0.85 (95% confidence interval [CI] 0.53-1.35; = .49, = 0%). The OR of the MACEs at 1 year was 0.61 (95% CI 0.36-1.05; = .08, = 0%). The OR of the MACEs at 5 years was 0.69 (95% CI 0.51-0.92; = .01, = 0%). Compared with the complex strategy, the simple strategy was associated with a lower incidence of MACEs at 5 years.
Compared to the complex stenting strategy, the simple stenting strategy can better reduce the occurrence of long-term MACEs for coronary bifurcation lesions.
冠状动脉分叉病变的支架置入仍然是一项挑战。虽然简单和复杂的支架置入策略都可行，但尚不清楚哪种策略能带来更好的临床结果。本荟萃分析旨在探讨这两种支架置入策略治疗后的长期预后。
通过检索PubMed、EMBASE和Cochrane对照试验中央注册库找到的随机对照试验纳入本荟萃分析。将复杂支架置入策略确定为对照组，简单支架置入策略确定为试验组。采用随机效应模型进行数据合成。通过Jadad量表评分评估随机对照试验的质量。分析6个月、1年和5年时的临床终点。
共有11项随机对照试验符合纳入标准。本荟萃分析共纳入2494例患者。6个月时主要不良心脏事件（MACE）的比值比（OR）为0.85（95%置信区间[CI]0.53 - 1.35；P = 0.49，I² = 0%）。1年时MACE的OR为0.61（95%CI 0.36 - 1.05；P = 0.08，I² = 0%）。5年时MACE的OR为0.69（95%CI 0.51 - 0.92；P = 0.01，I² = 0%）。与复杂策略相比，简单策略在5年时MACE的发生率较低。
与复杂支架置入策略相比，简单支架置入策略能更好地降低冠状动脉分叉病变长期MACE的发生。
