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PubMed Central
Other literature type . 2016
Data sources: PubMed Central
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Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Authors: Renjie Lu; Fenglei Tang; Yan Zhang; Xishan Zhu; Shanmei Zhu; Ganlin Wang; Yinfeng Jiang; +1 Authors

Comparison of Drug‐Eluting and Bare Metal Stents in Patients With Chronic Kidney Disease: An Updated Systematic Review and Meta‐Analysis

Abstract

Background Drug‐eluting stents ( DES s) and bare metal stents ( BMS s) are both recommended to improve coronary revascularization and to treat coronary artery disease in patients with chronic kidney disease ( CKD ). However, the potential superiority of DES s over BMS s for reducing the incidence of long‐term major adverse cardiovascular events and mortality in CKD patients has not been established, and the results remain controversial. We aimed to systematically assess and quantify the total weight of evidence regarding the use of DES s versus BMS s in CKD patients. Methods and Results In this systematic review and conventional meta‐analysis, electronic studies published in any language until May 20, 2016, were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials and observational studies comparing outcomes in CKD patients with DES s versus BMS s and extracted data in a standard form. Pooled odd ratios and 95% CIs were calculated using random‐ and fixed‐effects models. Finally, 38 studies involving 123 396 patients were included. The use of DES s versus BMS s was associated with significant reductions in major adverse cardiovascular events (pooled odds ratio 0.75; 95% CI , 0.64–0.88; P <0.001), all‐cause mortality (odds ratio 0.81; 95% CI , 0.73–0.90; P <0.001), myocardial infarction, target‐lesion revascularization, and target‐vessel revascularization. The superiority of DES s over BMS s for improving clinical outcomes was attenuated in randomized controlled trials. Conclusions The use of DES s significantly improves the above outcomes in CKD patients. Nevertheless, large‐sized randomized controlled trials are necessary to determine the real effect on CKD patients and whether efficacy differs by type of DES .

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Keywords

bare metal stent, cardiac, Myocardial Infarction, Drug-Eluting Stents, Comorbidity, Coronary Artery Disease, coronary disease, Treatment Outcome, Metals, cardiac biomarkers, RC666-701, Cause of Death, Myocardial Revascularization, Odds Ratio, dialysis, Diseases of the circulatory (Cardiovascular) system, Humans, Stents, Mortality, Renal Insufficiency, Chronic, chronic kidney disease, Original Research

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
18
Top 10%
Top 10%
Top 10%
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