Raffaele Piccolo1, Giulio G Stefanini1, Anna Franzone1, Ernest Spitzer1, Stefan Blöchlinger1, Dik Heg1, Peter Jüni1, Stephan Windecker2. 1. From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (R.P., G.G.S., A.F., E.S., S.B., S.W.); and Clinical Trials Unit (D.H., P.J., S.W.), Institute of Social and Preventive Medicine (D.H.), Institute of Primary Health Care (BIHAM) (P.J.), University of Bern, Bern, Switzerland. 2. From the Department of Cardiology, Bern University Hospital, Bern, Switzerland (R.P., G.G.S., A.F., E.S., S.B., S.W.); and Clinical Trials Unit (D.H., P.J., S.W.), Institute of Social and Preventive Medicine (D.H.), Institute of Primary Health Care (BIHAM) (P.J.), University of Bern, Bern, Switzerland. stephan.windecker@insel.ch.
Abstract
BACKGROUND: Although new-generation drug-eluting stents represent the standard of care among patients undergoing percutaneous coronary intervention, there remains debate about differences in efficacy and the risk of stent thrombosis between the Resolute zotarolimus-eluting stent (R-ZES) and the everolimus-eluting stent (EES). The aim of this study was to evaluate the safety and efficacy of the R-ZES compared with EES in patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: A systematic literature search of electronic resources was performed using specific search terms until September 2014. Random-effects meta-analysis was performed comparing clinical outcomes between patients treated with R-ZES and EES up to maximum available follow-up. The primary efficacy end point was target-vessel revascularization. The primary safety end point was definite or probable stent thrombosis. Secondary safety end points were cardiac death and target-vessel myocardial infarction. Five trials were identified, including a total of 9899 patients. Compared with EES, R-ZES had similar risks of target-vessel revascularization (risk ratio [RR], 1.06; 95% confidence interval [CI], 0.90-1.24; P=0.50), definite or probable stent thrombosis (RR, 1.26; 95% CI, 0.86-1.85; P=0.24), cardiac death (RR, 1.01; 95% CI, 0.79-1.30; P=0.91), and target-vessel myocardial infarction (RR, 1.10; 95% CI, 0.89-1.36; P=0.39). Moreover, R-ZES and EES had similar risks of late definite or probable very late stent thrombosis (RR, 1.06; 95% CI, 0.53-2.11; P=0.87). No evidence of significant heterogeneity was observed across trials. CONCLUSIONS: R-ZES and EES provide similar safety and efficacy among patients undergoing percutaneous coronary intervention.
BACKGROUND: Although new-generation drug-eluting stents represent the standard of care among patients undergoing percutaneous coronary intervention, there remains debate about differences in efficacy and the risk of stent thrombosis between the Resolute zotarolimus-eluting stent (R-ZES) and the everolimus-eluting stent (EES). The aim of this study was to evaluate the safety and efficacy of the R-ZES compared with EES in patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: A systematic literature search of electronic resources was performed using specific search terms until September 2014. Random-effects meta-analysis was performed comparing clinical outcomes between patients treated with R-ZES and EES up to maximum available follow-up. The primary efficacy end point was target-vessel revascularization. The primary safety end point was definite or probable stent thrombosis. Secondary safety end points were cardiac death and target-vessel myocardial infarction. Five trials were identified, including a total of 9899 patients. Compared with EES, R-ZES had similar risks of target-vessel revascularization (risk ratio [RR], 1.06; 95% confidence interval [CI], 0.90-1.24; P=0.50), definite or probable stent thrombosis (RR, 1.26; 95% CI, 0.86-1.85; P=0.24), cardiac death (RR, 1.01; 95% CI, 0.79-1.30; P=0.91), and target-vessel myocardial infarction (RR, 1.10; 95% CI, 0.89-1.36; P=0.39). Moreover, R-ZES and EES had similar risks of late definite or probable very late stent thrombosis (RR, 1.06; 95% CI, 0.53-2.11; P=0.87). No evidence of significant heterogeneity was observed across trials. CONCLUSIONS: R-ZES and EES provide similar safety and efficacy among patients undergoing percutaneous coronary intervention.
Authors: Rainer Zbinden; Raffaele Piccolo; Dik Heg; Marco Roffi; David J Kurz; Olivier Muller; André Vuilliomenet; Stéphane Cook; Daniel Weilenmann; Christoph Kaiser; Peiman Jamshidi; Anna Franzone; Franz Eberli; Peter Jüni; Stephan Windecker; Thomas Pilgrim Journal: J Am Heart Assoc Date: 2016-03-15 Impact factor: 5.501