Evaluation des endoprothèses coronaires à libération de principe actif - Drug eluting stents - A systematic review and meta-analysis of randomized clinical trials ; Cucherat M., 2008

Has

Description

Posted on Feb 19 2010 Rapport d'évaluation de la CEPP A summary statement in English will be available in due course. Posted on Feb 19 2010

Sujets

• Économie de la santé
• Cardiopathie coronarienne
• Cardiopathie
• Médecine

Informations

• Publié par: haute-autorite-sante-maladies-cardiaques
• Publié le: 01 juillet 2009
• Nombre de lectures: 13
• Licence : En savoir +
  Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique
• Langue: Français

Extrait

Prepared by:
Michel Cucherat, MD, PhD
Faculte de medecine Laennec
Lyon, France
[e-mail]
Drug eluting stents
A systematic review and meta-analysis of randomized clinical trials
2008 - 10 - 14
Prepared for
HAS
Part or all of the information presented in this document may be unpublished material and should be treated as
the con dential property of HAS, not to be divulged to unauthorized persons, in any form, including
publications and presentations, without the written consent of HAS.2CONTENTS 3
Contents
I Unparticular patients 7
1 Overview of available evidence for unparticular patients 9
1.1 Main results for Unparticular patients . . . . . . . . . . . . . . . . . . . . . . . . 14
1.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 14
1.3 versus paclitaxel eluting stent - summary of results . . . . . . . . . . 14
1.4 comparison versus sirolimus stent - of . . . . . . . . . . 15
2 Details for comparison versus bare-metal stent 29
2.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
2.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3 Details for comparison versus paclitaxel eluting stent 53
3.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
3.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
4 Details for comparison versus sirolimus eluting stent 66
4.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
4.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
5 Ongoing studies of Unparticular patients 75
5.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
II Diabetic patients 77
6 Overview of available evidence for diabetic patients 79
6.1 Main results for Diabetic patients . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
6.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 83
6.3 versus paclitaxel eluting stent - summary of results . . . . . . . . . . 83
6.4 comparison versus rapamycin stent - of . . . . . . . . . 83
7 Details for comparison versus bare-metal stent 92
7.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
7.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
8 Details for comparison versus paclitaxel eluting stent 103
8.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
8.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
9 Details for comparison versus rapamycin eluting stent 110
9.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
9.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
10 Ongoing studies of Diabetic patients 113
10.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1134 CONTENTS
III Acute myocardial infarction 115
11 Overview of available evidence for acute myocardial infarction 117
11.1 Main results for Acute myocardial infarction . . . . . . . . . . . . . . . . . . . . . 120
11.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 120
11.3 versus paclitaxel eluting stent - summary of results . . . . . . . . . . 120
12 Details for comparison versus bare-metal stent 129
12.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
12.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
13 Details for comparison versus paclitaxel eluting stent 140
13.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
13.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
14 Ongoing studies of Acute myocardial infarction 147
14.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
IV Small vessels 149
15 Overview of available evidence for small vessels 151
15.1 Main results for small vessels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
15.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 154
15.3 versus paclitaxel eluting stent - summary of results . . . . . . . . . . 154
16 Details for comparison versus bare-metal stent 160
16.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
16.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
17 Details for comparison versus paclitaxel eluting stent 166
17.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
17.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
18 Ongoing studies of small vessels 173
18.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
V Long or complex lesion 175
19 Overview of available evidence for long or complex lesion 177
19.1 Main results for long or complex lesion . . . . . . . . . . . . . . . . . . . . . . . . 181
19.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 181
19.3 versus CABG - summary of results . . . . . . . . . . . . . . . . . . . 181
19.4 comparison versus paclitaxel eluting stent - summary of results . . . . . . . . . . 181
20 Details for comparison versus bare-metal stent 189
20.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
20.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
21 Details for comparison versus CABG 197
21.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
21.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199CONTENTS 5
22 Details for comparison versus paclitaxel eluting stent 202
22.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
22.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
23 Ongoing studies of long or complex lesion 211
23.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
VI In-stent restenosis 213
24 Overview of available evidence for in-stent restenosis 215
24.1 Main results for in-stent restenosis . . . . . . . . . . . . . . . . . . . . . . . . . . 219
24.2 comparison versus ballon angioplasty - summary of results . . . . . . . . . . . . 219
24.3 versus brachytherapy - summary of results . . . . . . . . . . . . . . 219
24.4 comparison versus paclitaxel eluting stent - summary of results . . . . . . . . . . 219
25 Details for comparison versus ballon angioplasty 225
25.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
25.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
26 Details for comparison versus brachytherapy 230
26.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
26.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
27 Details for comparison versus paclitaxel eluting stent 236
27.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
27.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
28 Ongoing studies of in-stent restenosis 241
28.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
VII Bypass graft lesions 243
29 Overview of available evidence for bypass graft lesions 245
29.1 Main results for bypass graft lesions . . . . . . . . . . . . . . . . . . . . . . . . . 247
29.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 247
30 Details for comparison versus bare-metal stent 251
30.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
30.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
31 Ongoing studies of bypass graft lesions 257
31.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
VIII Unprotected left main coronary artery stenosis 259
32 Overview of available evidence for unprotected left main coronary artery
stenosis 261
32.1 Main results for unprotected left main coronary artery stenosis . . . . . . . . . . 263
32.2 comparison versus bare-metal stent - summary of results . . . . . . . . . . . . . 2636 CONTENTS
33 Details for comparison versus bare-metal stent 266
33.1 Available RCTs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
33.2 Meta-analysis results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
34 Ongoing studies of unprotected left main coronary artery stenosis 271
34.1 List of ongoing trials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
IX Total occ