Document Detail

Safety and efficacy of everolimus- versus sirolimus-eluting stents: A systematic review and meta-analysis of 11 randomized trials.
MedLine Citation:
PMID:  23351828     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: While EES have proven superior to paclitaxel-eluting stents, it remains uncertain whether EES improve clinical outcomes compared to SES, which are the most efficacious among the first-generation drug-eluting stents. We performed a meta-analysis of randomized trials comparing the efficacy and safety of everolimus-eluting stents (EES) versus sirolimus-eluting stents (SES) in patients undergoing percutaneous coronary intervention.
METHODS: From online and offline search until December 2011, we identified 11 randomized trials (total 12,869 patients). The primary endpoint was major adverse cardiac events.
RESULTS: The risk of major adverse cardiac events did not differ significantly between the patients treated with EES versus SES [OR, 0.90 (95% CI, 0.77-1.04); P = .162]. However, we found a significant reduction in the risk of repeat revascularization in the EES arm [OR, 0.85 (95% CI, 0.71-1.00); P = .047]. There were no significant differences regarding the risk of cardiac death [OR, 0.97 (95% CI, 0.74-1.27); P = .834], or myocardial infarction [OR, 0.95 (95% CI, 0.75-1.20), P = .656]. The risk of definite or probable stent thrombosis tended to be lower [OR, 0.68 (95% CI, 0.45-1.02); P = .065], while definite ST was significantly lower [OR, 0.44 (95% CI, 0.25-0.80); P = .007] with EES.
CONCLUSIONS: In a large systematic overview of comparative trials involving percutaneous revascularization with drug-eluting stents, treatment with EES significantly reduced the risk of repeat revascularization and definite ST compared to SES. We found no significant differences in the risk of cardiac death or myocardial infarction.
Kyung Woo Park; Si-Hyuck Kang; Matthijs A Velders; Dong-Ho Shin; Seokyung Hahn; Woo-Hyun Lim; Han-Mo Yang; Hae-Young Lee; Adrianus J Van Boven; Sjoerd H Hofma; Hyun-Jae Kang; Bon-Kwon Koo; Byung-Hee Oh; Young-Bae Park; David E Kandzari; Hyo-Soo Kim
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Publication Detail:
Type:  Journal Article     Date:  2012-12-27
Journal Detail:
Title:  American heart journal     Volume:  165     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  241-250.e4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea.
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