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生物可吸收支架治疗冠心病的五年结局:一项随机对照试验的系统评价和荟萃分析

Five-Year Outcomes of Bioresorbable Stent Therapy for Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Yang Fei-Fei, Song Hui, Qin Wei-Bin, Tang Wei-Zhi, Zhan Ling-Jun, Zhang Li-Wen, He Gui-Xin

机构信息

Graduate School, Guangxi University of Chinese Medicine, 530000 Nanning, Guangxi, China.

The Second Ward of the Department of Cardiovascular Medicine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, 530000 Nanning, Guangxi, China.

出版信息

Rev Cardiovasc Med. 2024 Jun 28;25(7):238. doi: 10.31083/j.rcm2507238. eCollection 2024 Jul.

Abstract

BACKGROUND

The efficacy of bioresorbable vascular scaffolds (BVS) compared to metallic stents for the treatment of coronary heart disease remains controversial. The analysis of clinical outcomes at five years following the initial treatment has yet to be reviewed. This study sought to assess the five-year outcomes in randomized controlled trials of BVS in the treatment of coronary heart disease using a systematic review and meta-analysis.

METHODS

A systematic database search was conducted from their inception to June 30th, 2023 using various Medical Subject Headings (MeSH) terms including: "Coronary Disease", "Bioresorbable stent", "Randomized controlled trials".

RESULTS

After a rigorous selection process, a total of five high-quality articles were finally included in this study. Each trial demonstrated a low risk of bias. After 5 years, bioresorbable stents showed outcomes similar to conventional metal stents in terms of cardiac mortality. However, they were inferior in terms of lesion revascularization rates, in-stent thrombosis rates, target lesion failure, target vessel failure, and myocardial infarction.

CONCLUSIONS

While bioresorbable stents are comparable to metallic stents in terms of cardiac mortality rates, they exhibit significant drawbacks that warrant clinical consideration.

摘要

背景

与金属支架相比,生物可吸收血管支架(BVS)治疗冠心病的疗效仍存在争议。初始治疗后五年的临床结果分析尚未得到综述。本研究旨在通过系统评价和荟萃分析评估BVS治疗冠心病随机对照试验的五年结果。

方法

从数据库建立至2023年6月30日进行系统检索,使用各种医学主题词(MeSH),包括:“冠心病”、“生物可吸收支架”、“随机对照试验”。

结果

经过严格筛选过程,本研究最终共纳入五篇高质量文章。每项试验显示偏倚风险较低。五年后,生物可吸收支架在心脏死亡率方面显示出与传统金属支架相似的结果。然而,在病变血运重建率、支架内血栓形成率、靶病变失败、靶血管失败和心肌梗死方面,生物可吸收支架较差。

结论

虽然生物可吸收支架在心脏死亡率方面与金属支架相当,但它们存在明显缺点,值得临床考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6109/11317335/a1165b72b27f/2153-8174-25-7-238-g1.jpg

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