Ten RCTs (n=6,192) were included in the review.
Significant heterogeneity was observed when assessing post-procedural TIMI flow 3, restenosis, reinfarction and target vessel revascularisation, so the results were presented using the random-effects model.
No significant difference between bare-metal stenting compared with balloon angioplasty was found with respect to the rates of multi-vessel disease (52% versus 51%), TIMI flow 0/1 before angioplasty (71% versus 74%), TIMI flow 3 after angioplasty (94% versus 93%), emergency coronary artery bypass grafting (2% versus 2%), or bleeding complications (defined as bleeding requiring transfusion or surgical repair, and intracerebral haemorrhage); 2% versus 2%).
Reocclusion was significantly less frequent after bare-metal stenting than after balloon angioplasty (7 trials): 6.7% versus 10.1% (OR 0.62, 95% CI: 0.40, 0.96, p=0.03). Similarly, there was significantly less restenosis after bare-metal stenting than after balloon angioplasty (7 trials): 23.9% versus 39.3% (OR 0.45, 95% CI: 0.34, 0.59, p<0.001). There was no significant difference in sub-acute thrombosis between the groups (6 trials): 1.7% versus 1.7% (OR 0.82, 95% CI: 0.42, 1.59, p=0.55).
There was no significant difference in all-cause mortality between the bare-metal stenting and balloon angioplasty groups. The OR for mortality at the longest available follow-up was 1.03 (95% CI: 0.82, 1.30, p=0.79). Similarly, there was no significant difference between the interventions in reinfarction rate (defined as recurrent chest pain with new ST segment elevation and recurrent increase of cardiac enzymes); the OR at the longest available follow-up was 0.86 (95% CI: 0.54, 1.37, p=0.54).
Target vessel revascularisation rates were 12.2% in the bare-metal stenting group and 19.2% in the balloon angioplasty group (OR 0.50, 95% CI: 0.37, 0.69, p<0.001).