LONG-TERM OUTCOMES OF DRUG-ELUTING STENTS VS. CONVENTIONAL ANGIOPLASTY: A SYSTEMATIC REVIEW

Abstract

Introduction: Cardiovascular diseases are the main cause of global morbidity and mortality, with coronary artery disease (CAD) being one of the main clinical manifestations. Percutaneous coronary intervention (PCI) has evolved considerably with the development of drug-eluting stents (DES), which deliver antiproliferative drugs to reduce restenosis, and alternatives such as drug-eluting balloons and resorbable scaffolds. This systematic review aims to compare the long-term clinical outcomes between DES and conventional angioplasty (CA), considering cardiovascular mortality, restenosis, and myocardial infarction. Methods: A systematic review was conducted according to the PRISMA guidelines, with searches in the PubMed database using MeSH descriptors and Boolean operators. Randomized studies published in the last five years comparing DES with CA were included. Case reports, editorials, and studies without a direct comparative group were excluded. The outcomes analyzed were cardiovascular mortality, restenosis rate, and incidence of myocardial infarction. Results: Four studies were included, totaling 774 patients. No studies reported cardiovascular mortality as the primary outcome. The restenosis rate was significantly lower with DES (26% vs. 56%, p<0.05). The incidence of infarction was lower in the DES group in one study (4.7% vs. 1.9%), while another showed identical incidence between DES and CA (33 events in each group). Conclusion: Drug-eluting stents demonstrate superiority in reducing restenosis and a trend towards a lower incidence of infarction, consolidating themselves as the preferred strategy for PCI. Future studies are needed to evaluate impacts on cardiovascular mortality and optimization of new therapeutic approaches.