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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.

Author information

1
Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II, University of Naples, Italy.

Abstract

BACKGROUND:

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).

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

PMID:
21315461
DOI:
10.1016/j.ijcard.2011.01.015
[Indexed for MEDLINE]

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