Related Experiment Video

Updated: Feb 2, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.8K

First-generation versus second-generation drug-eluting stents in patients with chronic kidney disease: a systematic

Wei-Dong Gao1, Min Ma2, Gao-Xing Zhang1

  • 1a Department of Cardiology , Jiangmen Central Hospital , Jiangmen , China.

Postgraduate Medicine
|November 14, 2018
PubMed

Insights

Second-generation drug-eluting stents (DES) show improved safety in chronic kidney disease (CKD) patients compared to first-generation DES. This meta-analysis found lower risks of mortality, restenosis, and stent thrombosis with second-generation DES in CKD patients.

Area of Science:

  • Cardiovascular medicine
  • Nephrology
  • Biomaterials science

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks of adverse cardiovascular events post-drug-eluting stent (DES) implantation.
  • The comparative clinical effectiveness of second-generation DES versus first-generation DES in this high-risk population remains a subject of debate.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis evaluating the safety and efficacy of second-generation DES compared to first-generation DES in patients with CKD.

Main Methods:

  • A comprehensive literature search of PubMed, EMBASE, and Cochrane Library identified relevant studies.
  • First-generation DES included sirolimus-eluting and paclitaxel-eluting stents; second-generation DES included everolimus-eluting, zotarolimus-eluting, and biolimus-eluting stents (BES).
  • Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated, alongside heterogeneity, subgroup, sensitivity, and publication bias analyses.

Main Results:

  • The analysis included 14 trials with 9,542 CKD patients undergoing percutaneous coronary intervention.
  • First-generation DES were linked to significantly higher risks of long-term all-cause mortality (OR, 1.31), in-stent restenosis (OR, 1.69), and stent thrombosis (OR, 1.64) compared to second-generation DES.
  • No significant differences were observed between the two generations regarding repeat revascularization, myocardial infarction (MI), or major adverse cardiac events (MACE).

Conclusions:

  • Second-generation DES demonstrate a reduced risk of long-term all-cause mortality, in-stent restenosis, and stent thrombosis in CKD patients compared to first-generation DES.
  • The efficacy in preventing repeat revascularization, MI, and MACE was comparable between first-generation and second-generation DES.
Abstract

Keywords:
First-generation stentschronic kidney diseasedialysisdrug-eluting stentspercutaneous coronary interventionsecond-generation stents

More Related Videos

Design of a Biocompatible Drug-Eluting Tracheal Stent in Mice with Laryngotracheal Stenosis08:26

Design of a Biocompatible Drug-Eluting Tracheal Stent in Mice with Laryngotracheal Stenosis

Published on: January 21, 2020

7.2K
Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia04:34

Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia

Published on: February 17, 2023

1.6K

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
728
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
653
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
472
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
392
Upper Respiratory Drugs: First and Second-Generation Antihistamines01:15

Upper Respiratory Drugs: First and Second-Generation Antihistamines

Antihistamines are a class of drugs widely used to alleviate the symptoms of allergies, such as sneezing, itching, and nasal congestion. They work by inhibiting the actions of histamine, which is released by immune cells in response to allergenic substances or tissue injuries.
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...
1.2K
Chronic Obstructive Pulmonary Disease01:24

Chronic Obstructive Pulmonary Disease

COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
2.5K