Efficacy and safety of single-stent strategy compared to a routine two-stent strategy for the treatment of bifurcation stenosis of the coronary arteries：A Meta-analysis
YU Zhi-min
ZHANG Fang-fang
ZHENG Ya-fen
ZHANG Li-juan
WANG Zhi-quan
Abstract：Objective To systematically review the efficacy and safety of single-stent strategy compared to a routine two-stent strategy for the treatment of bifurcation stenosis of the coronary arteries using drug-eluting stents. Methods We searched databases as Medline, EMBASE, and the Cochrane library (Issue 11, 2014), CNKI, VIP and WanFang until August 2015 for randomized controlled trials (RCTs). Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software.Results A total of 15 RCTs involving 3932 patients were included. The results of meta-analysis indicated that, overall mortality [RR=0.71,95%CI:0.44~1.13,P=0.15], target lesion revascularization rate (TVR) [RR=1.14, 95%CI: (0.91~1.43),P=0.26, stent thrombosis rate [RR=0.67, 95%CI:(0.41~1.10),P=0.11], main vessel restenosis rate [RR=1.23, 95%CI:(0.89~1.69),P=0.21] and side branch restenosis rate [RR=1.41, 95%CI:(0.95~2.09),P=0.09] had no difference between two strategies. Myocardial infarction (MI) rate was much lower using single stent strategy [RR=0.68, 95%CI:(0.55~0.84), P=0.0004]. Subgroup analysis of true bifurcation stenosis suggested that the similar results with two-stent strategy increased the risk of MI [RR=2.47, 95%CI:(1.49~4.08),P=0.0004].Conclusion Current evidence shows that single stent strategy was a safer and equal effective strategy compare to two-stent strategy. Due to limited quality and quantity of included studies, more large-scale high-quality RCTs will be needed to verify the above conclusion.
Keywords：Single-stent strategyTwo-stent strategyCoronary bifurcationMeta-analysis
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 150-155 )