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Int J Cardiol. 2011 Jul 1;150(1):84-9. doi: 10.1016/j.ijcard.2011.01.015. Epub 2011 Feb 18.

Twelve-month clinical outcomes of everolimus-eluting stent as compared to paclitaxel- and sirolimus-eluting stent in patients undergoing percutaneous coronary interventions. A meta-analysis of randomized clinical trials.

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Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II, University of Naples, Italy.



It is well established that both PES and SES reduce the need for reintervention as compared with bare-metal stents. Whether everolimus-eluting stent (EES) a "second-generation" drug-eluting stent, further improves clinical outcomes compared to PES and SES still remains uncertain. The aim of this study was to perform a meta-analysis of randomized trials evaluating safety and efficacy of EES compared with paclitaxel- (PES) and sirolimus-eluting stent (SES), in patients undergoing percutaneous coronary intervention (PCI).


We undertook a literature search using Medline, EMBASE, the Cochrane Central Register of Controlled Trials, scientific session abstracts and relevant websites, until August 2010. Included studies comprised randomized trials evaluating EES vs PES/SES, in patients undergoing PCI, at 1-year follow-up.


Five studies, enrolling 8058 patients, were included. At 12-month follow-up, patients treated with EES, as compared with PES/SES, experienced lower target-lesion revascularization (OR [95% CI] = 0.56 [0.45-0.70], p<0.00001) and myocardial infarction rates (OR [95% CI] = 0.57 [0.43-0.77], p = 0.0002), without difference in mortality (OR [95% CI] = 0.88 [0.62-1.24], p = 0.46). A trend towards lower stent thrombosis rates in favour of EES vs PES/SES was found (OR [95% CI] = 0.45 [0.20-1.01], p = 0.05). However, after the exclusion of SES, EES significantly reduced stent thrombosis as compared with PES (OR [95% CI] = 0.35 [0.14-0.86], p = 0.02).


At 12-month follow-up, treatment with EES is associated with decreased target-lesion revascularization and myocardial infarction rates, without differences in mortality, as compared with PES/SES. EES vs PES/SES use is associated with a trend towards lower stent thrombosis rates. Moreover, EES significantly reduce stent thrombosis with respect to PES.

[Indexed for MEDLINE]

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