Twenty-five studies were included in the review (5,755 participants): two RCTs (155 participants), one secondary subgroup analysis of a RCT (47 participants), six prospective non-randomised studies (2,045 participants), one prospective and retrospective case-control study (350 participants) and 15 retrospective studies (3,158 participants).
Use of drug-eluting stents was associated with a significant reduction in risks of target vessel revascularisation (OR 0.55, 95% CrI 0.39 to 0.76; 20 studies, 4,130 participants) and target lesion revascularisation (OR 0.58, 95% CrI 0.37 to 0.87; 17 studies, 3,592 participants) compared to bare metal stents. There were no significant differences between groups for TVR and TLR when only RCTs were considered.
Use of drug-eluting stents was associated with a 38% reduction in the risk of major adverse cardiac events (OR 0.62, 95% CrI 0.46 to 0.81; 24 studies, 5,074 participants) compared to bare metal stents; this difference did not exist when only RCTs were considered.
Use of drug-eluting stents was not associated with a reduction in risks for mortality, myocardial infarction and stent thrombosis. However, drug-eluting stents significantly reduced mortality when only observational studies were considered, OR 0.75 (95% CrI 0.58 to 0.98; 21 studies, 4,949 participants).
Sub-analysis revealed that drug-eluting stents showed a significant reduction in risk of MACE and TVR from 18 to 30 months.