{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T05:12:17Z","timestamp":1774674737269,"version":"3.50.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The relative safety of drug-eluting stents (DESs) and bare-metal stents (BMSs) with respect to stent thrombosis (ST) continues to be debated. There are limited data comparing safety and efficacy of second-generation DES to BMS. We compared the clinical outcomes between second-generation DES and BMS for primary percutaneous coronary intervention using network meta-analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Randomized controlled trials comparing stent types (first-generation DES, second-generation DES or BMS) were considered for inclusion. A search strategy used Medline, Embase, Cochrane databases, and proceedings of the international meetings. Information about study design, inclusion criteria, and sample characteristics were extracted. Network meta-analysis was used to pool direct (comparison of second-generation DES to BMS) and indirect evidence (first-generation DES with BMS and second-generation DES) from the randomized trials. Twenty-one trials comparing all stents types, including 12 866 patients randomly assigned to treatment groups, were analyzed. A significantly lower incidence of ST was noted with the use of second-generation DES as early as 30 days (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.15\u20130.82) and between 31 days and 1 year (OR, 0.49; 95% CI, 0.30\u20130.79) when compared with BMS. Second-generation DES was associated with significantly lower incidence of definite ST at 1 year (OR, 0.3; 95% CI, 0.11\u20130.83) and myocardial infarction (OR, 0.3; 95% CI, 0.17\u20130.54) and target vessel revascularization at 1 year (OR, 0.54; 95% CI, 0.80\u20130.98) when compared with BMS. There was no difference in mortality at 30 days (OR, 0.84; 95% CI, 0.45\u20131.59) or 1 year (OR, 0.80; 95% CI, 0.56\u20131.14) with the use of second-generation DES versus BMS. The small number of events may influence the precision of the analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Network meta-analysis of randomized trials of primary percutaneous coronary intervention demonstrated lower incidence of ST, myocardial infarction, and target vessel revascularization with second-generation DES when compared with BMS. The use of second-generation DES for percutaneous coronary intervention in ST-segment\u2013elevation myocardial infarction was not associated with adverse events when compared with BMS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.113.000412","type":"journal-article","created":{"date-parts":[[2013,11,27]],"date-time":"2013-11-27T05:10:24Z","timestamp":1385529024000},"page":"49-61","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Stent Thrombosis With Second-Generation Drug-Eluting Stents Compared With Bare-Metal Stents"],"prefix":"10.1161","volume":"7","author":[{"given":"Femi","family":"Philip","sequence":"first","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikhar","family":"Agarwal","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Bunte","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin S.","family":"Goel","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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