Fifteen studies were included in the meta-analysis (n=5,479 patients; range 153 to 792); two were RCTs (n=864) and 13 were observational studies. Follow-up ranged from one to five years.
There was no significant difference in mortality, myocardial infarction, or cerebrovascular events in the first 30 days after drug-eluting stents or coronary artery bypass grafting surgery (six studies). There was also no significant difference in mortality during longer-term folow-up.
There was a significant increase in the rate of revascularisation after drug-eluting stents at one year (OR 5.0, 95% CI 2.85 to 8.77; I2=68%; 11 RCTs), two years (OR 4.79, 95% CI 2.72 to 8.45; I2=51%; four RCTs), three years (OR 5.72, 95% CI 3.07 to 10.65; I2=67%; four RCTs), four years (OR 2.16, 95% CI 1.17 to 4.01; one RCT) and five years (OR 5.65, 95% CI 3.44 to 9.27; I2=0%; two RCTs).
Results of the sensitivity analyses were similar to those of the overall results.
There was no evidence of publication bias; three studies were calculated as being needed to achieve a symmetrical funnel plot.