冠状动脉药物洗脱支架断裂的发生率：一项系统评价与荟萃分析。
Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis.
作者信息
Chen Yang, Li Dandan, Liao Yanhui, Yao Xiongda, Ruan Yuehua, Zou Kai, Liao Hanhui, Ding Jingwen, Qin Hao, Yu Zuozhong, Zhao Yuanbin, Hu Longlong, Yang Renqiang
机构信息
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
出版信息
Front Cardiovasc Med. 2022 Aug 23;9:925912. doi: 10.3389/fcvm.2022.925912. eCollection 2022.
BACKGROUND
Reported evidence of coronary stent fracture (CSF) has increased in recent years. The purpose of this study was to determine reliable estimates of the overall incidence of CSF.
METHODS AND RESULTS
The MEDLINE, Embase and Cochrane databases were searched until March 18, 2022. Pooled estimates were acquired using random effects models. Meta-regression and subgroup analysis were used to explore sources of heterogeneity, and publication bias was evaluated by visual assessment of funnel plots and Egger's test. Overall, 46 articles were included in this study. Estimates of CSF incidence were 5.5% [95% confidence interval (CI): 3.7-7.7%] among 39,953 patients based on 36 studies, 4.8% (95% CI: 3.1-6.8%) among 39,945 lesions based on 29 studies and 4.9% (95% CI: 2.5-9.4%) among 19,252 stents based on 8 studies. There has been an obvious increase in the incidence of CSF over the past two decades, and it seems that the duration of stent placement after stent implantation has no impact on incidence estimation.
CONCLUSION
The incidence of CSF was 5.5% among patients, 4.8% for lesions and 4.9% for stents and increased over the past 20 years. The duration of stent placement after stent implantation was found to have no impact on the incidence of CSF, but drug-eluting stent (DES) types and right coronary artery (RCA) lesions influenced the pooled incidence.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022311995], identifier [CRD42022311995].
背景
近年来，冠状动脉支架断裂（CSF）的报道证据有所增加。本研究的目的是确定CSF总体发生率的可靠估计值。
方法与结果
检索MEDLINE、Embase和Cochrane数据库至2022年3月18日。使用随机效应模型获得合并估计值。采用Meta回归和亚组分析探讨异质性来源，并通过漏斗图的视觉评估和Egger检验评估发表偏倚。本研究共纳入46篇文章。基于36项研究的39953例患者中，CSF发生率估计为5.5%[95%置信区间（CI）：3.7-7.7%]；基于29项研究的39945个病变中，CSF发生率为4.8%（95%CI：3.1-6.8%）；基于8项研究的19252个支架中，CSF发生率为4.9%（95%CI：2.5-9.4%）。在过去二十年中，CSF的发生率有明显增加，并且似乎支架植入后支架放置的持续时间对发生率估计没有影响。
结论
CSF在患者中的发生率为5.5%，病变为4.8%，支架为4.9%，且在过去20年中有所增加。发现支架植入后支架放置的持续时间对CSF的发生率没有影响，但药物洗脱支架（DES）类型和右冠状动脉（RCA）病变影响合并发生率。
系统评价注册
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022311995]，标识符[CRD42022311995]。
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