Document Detail


Stent thrombosis with everolimus-eluting stents: meta-analysis of comparative randomized controlled trials.
MedLine Citation:
PMID:  22668554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Some but not all studies have reported reduced rates of stent thrombosis (ST) with everolimus-eluting stents (EES) compared with other drug-eluting stents (DES). All of these studies were insufficiently powered to reliably detect differences in ST. We therefore performed a meta-analysis of randomized controlled trials comparing the risk of 2-year definite ST between EES and other DES.
METHODS AND RESULTS: Randomized controlled trials comparing EES versus other DES were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. Information on study design, inclusion and exclusion criteria, sample characteristics, and clinical outcomes was extracted. Eleven randomized controlled trials (16,775 patients) were analyzed, including 5 trials (n=7113) of EES versus paclitaxel-eluting stents, 5 trials (n=7370) of EES versus sirolimus-eluting stents, and 1 trial (n=2292) of EES versus zotarolimus-eluting stents. By 2 years definite ST with EES compared with pooled DES occurred in 0.5% versus 1.3% patients, respectively (relative risk, 0.38; 95% CI, 0.24-0.59; P<0.0001). Similar results were observed when the broader definition of definite/probable ST was considered (relative risk, 0.46; 95% CI, 0.33-0.66; P<0.0001). EES compared with other DES reduced the relative risk of early ST (within 30 days), late ST (31 days to 1 year), cumulative 1-year ST, and very late ST (1-2 years). The reduced rate of definite ST observed with EES was consistent across all DES comparators with no interactions apparent during any time interval.
CONCLUSIONS: EES compared with a pooled group of paclitaxel-eluting stents, sirolimus-eluting stents, and zotarolimus-eluting stents is associated with a significant reduction of definite ST, an effect that appears early and increases in magnitude through at least 2 years.
Authors:
Tullio Palmerini; Ajay J Kirtane; Patrick W Serruys; Pieter C Smits; Elvin Kedhi; Dean Kereiakes; Diego Sangiorgi; Letizia Bacchi Reggiani; Christoph Kaiser; Hyo-Soo Kim; Antoinette De Waha; Flavio Ribichini; Gregg W Stone
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2012-06-05
Journal Detail:
Title:  Circulation. Cardiovascular interventions     Volume:  5     ISSN:  1941-7632     ISO Abbreviation:  Circ Cardiovasc Interv     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-20     Completed Date:  2012-10-23     Revised Date:  2012-12-12    
Medline Journal Info:
Nlm Unique ID:  101499602     Medline TA:  Circ Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-64     Citation Subset:  IM    
Affiliation:
Istituto di Cardiologia, Policlinico S. Orsola, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Chi-Square Distribution
Coronary Thrombosis / etiology,  mortality,  prevention & control*
Drug-Eluting Stents*
Evidence-Based Medicine
Humans
Myocardial Infarction / etiology,  prevention & control
Odds Ratio
Prosthesis Design
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
Sirolimus / administration & dosage,  analogs & derivatives*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 159351-69-6/everolimus; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
Circ Cardiovasc Interv. 2012 Jun;5(3):332-5   [PMID:  22715449 ]
Circ Cardiovasc Interv. 2012 Oct;5(5):e72; author reply e73   [PMID:  23074352 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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