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\begin{document}

\title{Comparison of the safety and efficacy of between second-generation and
first-generation drug eluting stents in patients with left main coronary
artery stenosis: A systematic review and meta-analysis}



\author[1]{XiaoFei Gao}%
\author[2]{Mei-Jun Liu}%
\author[2]{Yi-Zhou  Xu}%
\affil[1]{Hangzhou First People's Hospital}%
\affil[2]{Affiliation not available}%


\vspace{-1em}



  
  \date{May 07, 2024}


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\begin{abstract}
Objective: The aim of this meta-analysis was to compare the safety and
efficacy of second-generation and first-generation drug eluting stents
(DES) for the treatment of left main coronary artery (LMCA) stenosis.
Background: Studies have evaluated the safety and efficacy of between
second-generation and first-generation DES in LMCA stenosis patients and
the results of these studies were inconsistent. Methods: PubMed, EmBase
and Cochrane Library were searched to identify eligible studies
comparing the safety and efficacy of second-generation DES and
first-generation DES for the treatment of LMCA stenosis. Odds ratios
(ORs) with 95\% confidence intervals (CIs) were used to summary the
estimates. Results: We identified 11 studies (1 was RCTs and 10 were
observational studies) involving 4345 LMCA patients who treated with
second-generation and first-generation DES. Second-generation DES had
lower risk of MACE (15.4\% vs.18.5\%; OR 0.69 (0.52, 0.91); P=0.009),
stent thrombosis (1.1\% vs.2.4\%; OR 0.46 (0.28, 0.74); P=0.001) , TVR
(6.8\% vs.13.4\%; OR 0.48 (0.35, 0.66); P<0.0001) , and MI (1.6\%
vs.3.5\%; OR 0.58 (0.35, 0.94); P=0.03) compared with first-generation
DES. There were no differences in the risks of all-cause mortality
(6.8\% vs.7.9\%; OR 0.88 (0.68, 1.15); P=0.36), cardiac mortality (3.4\%
vs.4.5\%; OR 0.73 (0.51, 1.03); P=0.07), and TLR (8.7\% vs.7.8\%; OR
1.09 (0.86, 1.39); P=0.48) between second-generation and
first-generation DES. Conclusions: In LCMA patients, compared with
first-generation DES, second-generation DES was associated with lower
risk of MACE, stent thrombosis, TVR, and MI. No differences were found
with respect to all-cause death, cardiac death, and TLR. Key words:
Second-generation stents; Drug-eluting stents; Percutaneous coronary
intervention; Left main; Meta-analysis%
\end{abstract}%



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