Učinkovitost i sigurnost intrakoronarnih stentova u bolesnika s akutnim stemi

Introduction: This meta-analysis investigates and reevaluates the efficacy and safety of variousintracoronary stents after acute ST-elevation myocardial infarction (STEMI).Methods: PubMed/ScienceDirect databases were systematically searched for Randomized ControlledTrials (RCTs) w2ith outcomes after acute STEMI in relation to stent type. During follow-up, the efficacyoutcomes were target lesion revascularization (TLR) and target vessel revascularization (TVR), while thesafety outcomes were overall death, cardiac death, myocardial infarction, total in-stent thrombosis (IST)and major adverse cardiovascular events/target vessel failure (MACE/TVF) (the composite ofoverall/cardiac death, myocardial infarction, TLR and TVR). Stents were classified as bare-metal stent(BMS), drug-eluting stent of the first (DES1st) and second-generation (DES2nd), and biodegradable polymerDES (BP-DES).Results: We included 31 RCTs, with 17,010 participants (74.6% males), with an average age of 61.2years. During the average 35-month follow-up, DES are preferred over BMS in reducing the risk of TLR(odds ratio (OR) = 0.47, confidence interval (CI) [0.41-0.54]), TVR (OR = 0.54, CI [0.47-0.61]), overalldeath (OR = 0.85, CI [0.74-0.99]) and MACE/TVF (OR = 0.61, CI [0.55-0.68]); DES2nd are preferred overDES1st in reducing the risk of myocardial infarction (OR = 0.61, CI [0.39-0.96]), IST (OR = 0.41, CI [0.22-0.73]) and MACE/TVF (OR = 0.70, CI [0.54-0.90]); and, BP-DES are preferred over DES2nd in reducingthe risk of TLR (OR = 0.55, CI [0.35-0.86]) and IST (OR = 0.56, CI [0.33-0.96]) (for all P<0.05).Conclusion: After acute STEMI, DES are superior to BMS in efficacy and safety, DES2nd to DES1st insafety, and BP-DES to DES2nd in efficacy and safety.