Coronary stent infection is a rare yet serious complication of coronary artery stenting, with potentially significant morbidity and mortality. This systematic review aimed to comprehensively assess the available evidence on the diagnosis, management, and outcomes of coronary stent infection. A comprehensive search of electronic databases, including PubMed, Embase, Cochrane Library, and Scopus, was conducted from inception until March 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1 case series and 41 case reports, covering a cumulative sample size of 44 patients, were included in the analysis. The predominant stent types were drug-eluting stents in 22 studies, bare-metal stents in 3 studies, and a combination of drug-eluting stents and bare-metal stents in 4 studies. Staphylococcus aureus was the predominant identified organism in microbiological profiles. Primary outcomes, including mortality, morbidity, and recurrence rates, were evaluated. The aggregate mortality rate across studies was 18%, underscoring the severity of coronary stent infections. Morbidity ranged from 3% to 60%, with a spectrum of complications such as sepsis, heart failure, and embolic events. Recurrence rates varied from 3% to 33%, emphasizing the importance of effective management. Treatment strategies encompassed antibiotics alone, antibiotics with stent removal, and antibiotics with stent retention, with the duration of antibiotic therapy ranging from 2 weeks to 12 months. The optimal management strategy remains uncertain due to limited high-quality evidence. Early diagnosis and treatment were emphasized as critical factors in improving outcomes. Prophylactic antibiotics during stenting procedures and increased awareness among healthcare providers were suggested as preventive measures.

中文翻译：

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冠状动脉支架感染：文献系统回顾。

冠状动脉支架感染是冠状动脉支架置入术中罕见但严重的并发症，具有潜在的显着发病率和死亡率。本系统综述旨在全面评估冠状动脉支架感染的诊断、治疗和结果的现有证据。根据系统评价和荟萃分析指南的首选报告项目，从成立到 2023 年 3 月，对包括 PubMed、Embase、Cochrane Library 和 Scopus 在内的电子数据库进行了全面检索。分析共纳入 1 个病例系列和 41 个病例报告，累计样本量为 44 名患者。22 项研究中主要的支架类型是药物洗脱支架，3 项研究中是裸金属支架，4 项研究中是药物洗脱支架和裸金属支架的组合。金黄色葡萄球菌是微生物学特征中鉴定出的主要微生物。评估了主要结局，包括死亡率、发病率和复发率。各项研究的总死亡率为 18%，凸显了冠状动脉支架感染的严重性。发病率从 3% 到 60% 不等，伴有脓毒症、心力衰竭和栓塞事件等一系列并发症。复发率从 3% 到 33% 不等，强调了有效管理的重要性。治疗策略包括单独使用抗生素、抗生素联合支架取出和抗生素保留支架，抗生素治疗的持续时间从2周到12个月不等。由于高质量证据有限，最佳管理策略仍不确定。强调早期诊断和治疗是改善结果的关键因素。建议在支架置入术期间预防性使用抗生素并提高医疗保健提供者的认识作为预防措施。