Objective: To compare the efficacy of limus-eluting stent (LES) with paclitaxel-eluting stent (PES) for patients with coronary small vessel disease.
Methods: The studies of LES and PES used for patients with coronary small vessel disease were searched in PubMed, Web of Science, ClinicalTrials, SinoMed, CNKI, Wanfang data and CQVIP. The relative risk (RR) estimates with 95% confidence intervals and other statistical variables were calculated with Stata 14.0, and the meta analysis was performed with RevMan 5.2.
Results: Eight studies involving 4738 patients were included in the meta-analysis. Compared with PES, LES implantation was associated with significant reduction in major adverse cardiovascular events (RR=0.64, 95% CI:0.53-0.77, Z=4.59, P<0.01), myocardial infarction (RR=0.61, 95% CI:0.45-0.82; Z=3.24, P<0.01), stent thrombosis (RR=0.22, 95% CI:0.13-0.37, Z=5.71, P<0.01), and target lesion revascularization (RR=0.56, 95% CI:0.44-0.71, Z=4.72, P<0.01), while no difference was observed in cardiac death (RR=1.08, 95% CI:0.62-1.88, Z=0.26, P>0.05) and target vessel revascularization(RR=0.80, 95% CI:0.45-1.44, Z=0.74, P>0.05).
Conclusions: LES has better efficacy than PES for patients with coronary small vessel disease, which may be the preferred stents for these patients.
目的: 比较莫司类药物洗脱支架（LES）与紫杉醇洗脱支架（PES）在冠状动脉小血管病变患者中的疗效。
方法: 通过PubMed、Web of Science、ClinicalTrials、中国生物医学文献数据库、中国知网、万方数据和维普数据库对与本次研究主题相关的文献进行检索，对纳入的文献进行方法学质量评价。采用RevMan 5.2及Stata 14.0软件进行相关的统计学分析。
结果: 八项研究共4738例患者纳入此研究。与PES比较，植入LES能减少主要心血管不良事件（ RR=0.64，95% CI：0.53~0.77， Z=4.59， P < 0.01）、心肌梗死（ RR=0.61，95% CI：0.45~0.82， Z=3.24， P < 0.01）、支架内血栓（ RR=0.22，95% CI：0.13~0.37， Z=5.71， P < 0.01）以及靶病变血运重建（ RR=0.56，95% CI：0.44~0.71， Z=4.72， P < 0.01）的发生率。与PES比较，LES不能减少心因性死亡（ RR=1.08，95% CI：0.62~1.88， Z=0.26， P>0.05）和靶血管血运重建事件的发生率（ RR=0.80，95% CI：0.45~1.44， Z=0.74， P>0.05）。
结论: 对于冠状动脉小血管病变行经皮冠脉介入支架植入术的患者，LES较PES有更好的长期疗效，可作为该类患者的首选支架。