Is In-Stent Late Loss Related to the Risk of Drug-Eluting Stent Thrombosis?
In-Stent Late Loss 与DES血栓风险有关吗？
Background: The benefit of drug-eluting stents (DES) in reducing binary angiographic restenosis and the need for new revascularizations is due to a reduction of in-stent late loss (ISLL) in comparison with bare-metal stents. The aim was to evaluate whether there is any relationship between ISLL and the risk of ST in patients treated with DES.
Methods: We selected 21 randomized trials comparing bare-metal stents and DES that provided a clinical and angiographic follow-up: RAVEL, SIRIUS, E-SIRIUS, C-SIRIUS, DIABETES, SCANDSTENT, SES-SMART, PRISON-II, the study by Pache et al (sirolimus DES), TAXUS-I, TAXUS-II, TAXUS-IV, TAXUS-V, TAXUS-VI (paclitaxel DES), JUPITER-I, JUPITER-II (tacrolimus DES), FUTURE-I, FUTURE-II, SPIRIT-I (everolimus DES), ENDEAVOR-II (zotarolimus DES), and STEALTH (biolimus DES). The relationship between the mean value of ISLL and the incidence of ST in patients allocated to DES in each trial was evaluated, using meta-regression techniques, and weigthing the results for the number of patients in each trial.
Results: The results revealed an absence of relationship between the mean value of ISLL and the incidence of ST in each trial: Y = 0.65 + 0.24 (X), where “Y” is the risk of  ST, and “X” the mean value of ISLL (P = 0.798).
Conclusions: The risk of ST after DES implantation is not related with ISLL.A very low mean value of ISLL is not associated with higher risk of ST.
背景: DES 可以减少双重性血管造影血栓的发生，与裸支架相比新的血管在形成的需要要根据在ISLL的减少多少而定。目的就是验证一下在病人体内植入DES所出现的ST风险和ISLL是否有关系。
方法：我们随机选择了21组试验，将裸支架与DES作比较，并提供了一些临床血管造影的资料，RAVEL, SIRIUS, E-SIRIUS, C-SIRIUS, DIABETES, SCANDSTENT, SES-SMART, PRISON-II, the study by Pache et al (sirolimus DES), TAXUS-I, TAXUS-II, TAXUS-IV, TAXUS-V, TAXUS-VI (paclitaxel DES), JUPITER-I, JUPITER-II (tacrolimus DES), FUTURE-I, FUTURE-II, SPIRIT-I (everolimus DES), ENDEAVOR-II (zotarolimus DES), and STEALTH (biolimus DES)，通过meta-regression技术等来检验每组试验数字结果，观察病人植入DES的ST情况与ISLL平均价值的关系。
结果：结果显示，在每组试验中ISLL平均值和ST范围没有关系。
结论：在病人体内移入DES后的ST风险与ISLL并没有关系。ISLL非常低的平均值和ST 的高风险也没有关系。
               

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