Hongqiu Gu1, Kun Hua1, Wei Li2, Yang Wang1, Jingan Yang1. 1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, People's Republic of China; Peking Union Medical College, Beijing 100037, People's Republic of China. 2. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, People's Republic of China; Peking Union Medical College, Beijing 100037, People's Republic of China. Electronic address: liwei@mrbc-nccd.com.
Abstract
BACKGROUND: The safety and efficacy of everolimus-eluting stent (EES) versus zotarolimus-eluting stent (ZES) are controversial both in randomized controlled clinical trials (RCTs) and observational studies. The aim of this study was to assess the safety and efficacy of EES versus ZES. METHODS: Pubmed, Embase, Cochrane database and www.clinicaltrials.gov updated to Mar 2014 with safety [major adverse cardiac events (MACE)], all-cause mortality, non-fatal myocardial infarction (MI), stent thrombosis (ST) and efficacy [target vessel revascularization (TVR), target lesion revascularization (TLR), target vessel failure (TVF), target lesion failure (TLF)] endpoints and follow-up of ≥12 months were identified. RESULTS: Data from 11,778 patients in 8 RCTs and 34,850 patients in 26 observational studies were included. In RCT studies, no evidence indicating that EES was safer or more efficacious than ZES. In observational studies, EES associated with a significantly lower risk for MACE (RR: 0.56, 95% CI: 0.46-0.69), ST (RR: 0.59, 95% CI: 0.45-0.78), TVR (RR: 0.61, 95% CI: 0.47-0.79), TLR (RR: 0.57, 95% CI: 0.38-0.83) and TLF (RR: 0.69, 95% CI: 0.50-0.93). The pooled data of RCTs and observational studies showed that compared to ZES, EES associated with a significant lower risk for MACE (RR: 0.65, 95% CI: 0.54-0.78), ST (RR: 0.66, 95% CI: 0.52-0.83), TVR (RR: 0.72, 95% CI: 0.58-0.89), TLR (RR: 0.63, 95% CI: 0.49-0.82) and TLF (RR: 078, 95% CI: 0.62-1.00). CONCLUSIONS: In RCTs, EES and ZES showed comparable safety and efficacy, while in observational studies or pooled data, EES was safer and more efficacious than ZES.
BACKGROUND: The safety and efficacy of everolimus-eluting stent (EES) versus zotarolimus-eluting stent (ZES) are controversial both in randomized controlled clinical trials (RCTs) and observational studies. The aim of this study was to assess the safety and efficacy of EES versus ZES. METHODS: Pubmed, Embase, Cochrane database and www.clinicaltrials.gov updated to Mar 2014 with safety [major adverse cardiac events (MACE)], all-cause mortality, non-fatal myocardial infarction (MI), stent thrombosis (ST) and efficacy [target vessel revascularization (TVR), target lesion revascularization (TLR), target vessel failure (TVF), target lesion failure (TLF)] endpoints and follow-up of ≥12 months were identified. RESULTS: Data from 11,778 patients in 8 RCTs and 34,850 patients in 26 observational studies were included. In RCT studies, no evidence indicating that EES was safer or more efficacious than ZES. In observational studies, EES associated with a significantly lower risk for MACE (RR: 0.56, 95% CI: 0.46-0.69), ST (RR: 0.59, 95% CI: 0.45-0.78), TVR (RR: 0.61, 95% CI: 0.47-0.79), TLR (RR: 0.57, 95% CI: 0.38-0.83) and TLF (RR: 0.69, 95% CI: 0.50-0.93). The pooled data of RCTs and observational studies showed that compared to ZES, EES associated with a significant lower risk for MACE (RR: 0.65, 95% CI: 0.54-0.78), ST (RR: 0.66, 95% CI: 0.52-0.83), TVR (RR: 0.72, 95% CI: 0.58-0.89), TLR (RR: 0.63, 95% CI: 0.49-0.82) and TLF (RR: 078, 95% CI: 0.62-1.00). CONCLUSIONS: In RCTs, EES and ZES showed comparable safety and efficacy, while in observational studies or pooled data, EES was safer and more efficacious than ZES.
Authors: Paolo Zocca; Marlies M Kok; Liefke C van der Heijden; Peter W Danse; Carl E Schotborgh; Martijn Scholte; Marc Hartmann; Gerard C M Linssen; Carine J M Doggen; Clemens von Birgelen Journal: Cardiovasc Drugs Ther Date: 2018-12 Impact factor: 3.727