Table of Contents
Thrombosis
Volume 2012, Article ID 126369, 8 pages
http://dx.doi.org/10.1155/2012/126369
Clinical Study

Everolimus-Eluting versus Paclitaxel-Eluting Stents in Percutaneous Coronary Intervention: Meta-Analysis of Randomized Trials

Departments of Medine and Cardiology, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada L8L 2X2

Received 19 November 2011; Revised 30 January 2012; Accepted 21 February 2012

Academic Editor: Alaide Chieffo

Copyright © 2012 Ashraf Alazzoni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Individual randomized trials have suggested that everolimus-eluting stents may have improved clinical outcomes compared to paclitaxel-eluting stents, but individual trials are underpowered to examine outcomes such as mortality and very late stent thrombosis. Methods. Medline, Cochrane, and conference proceedings were searched for randomized trials comparing everolimus versus paclitaxel-eluting stents for percutaneous coronary intervention. Results. 6792 patients were included from 4 randomized controlled trials. Stent thrombosis was reduced with everolimus stents versus paclitaxel stents (0.7% versus 2.3%; OR: 0.32; CI: 0.20–0.51; ). The reductions in stent thrombosis were observed in (i) early stent thrombosis (within 30 days) (0.2% versus 0.9%; OR: 0.24; ), (ii) late (day 31–365) (0.2% versus 0.6%; OR: 0.32; ), and (iii) very late stent thrombosis (>365 days) (0.2% versus 0.8%; OR: 0.34; ). The rates of cardiovascular mortality were 1.2% in everolimus group and 1.6% in paclitaxel group (OR: 0.85; ). Patients receiving everolimus-eluting stents had significantly lower myocardial infarction events and target vessel revascularization as compared to paclitaxel-eluting stents. Interpretation. Everolimus compared to paclitaxel-eluting stents reduced the incidence of early, late, and very late stent thrombosis as well as target vessel revascularization.