Safety and efficacy of everolimus-eluting stent versus zotarolimus-eluting stent: A meta-analysis of randomized controlled clinical trials and observational studies

Gu, Hongqiu; Hua, Ke; Li, Wei; Wang, Yang; Yang, Jinfeng

doi:10.1016/j.ijcard.2015.02.097

Cited by 7 publications

(7 citation statements)

References 39 publications

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“…Our results are generally consistent with results from a meta-analysis summarizing prior observational studies on comparative effectiveness of ZES vs. EES. [11] The meta-analysis reported that EES significantly reduced the rate of target vessel revascularization (RR = 0.61, 95% CI: 0.47-0.79, P<0.001) based on 8 previous observational studies with the total sample size of 12,299. The meta-analysis also found that target lesion revascularization (RR = 0.57, 95% CI: 0.38-0.83, P=0.004) relative to ZES based on 13 prior observational studies with a total sample size of 14,589.…”

Section: Discussionmentioning

confidence: 97%

“…Recent randomized clinical trials have reported that use of EES leads to better or similar safety and efficacy relative to use of E-ZES over a 3-year follow-up period. [9][10][11] However, it remains unknown whether patients receiving EES have better long-term outcomes compared with patients receiving E-ZES in real-world settings and whether such comparative advantages exist for "off-label" and "high risk" patient subgroups. To fill these knowledge gaps, high-quality cardiac registries can be used because they provide real-world clinical data for a much broader patient population that includes all providers and hospitals in a specific geographical region.…”

Section: Introductionmentioning

confidence: 99%

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Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York

Qian¹,

Ye²,

Hannan³

2017

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York

Qian¹,

Ye²,

Hannan³

2017

International Journal of Cardiology

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“…In addition, in our HBR patients, event rates were lower than in the zotarolimus-eluting DP-DES arm of the ZEUS trial [ 15 ] for: death (all-cause: 3.8 versus 15.8%; cardiac: 1.4 versus 11.8%); revascularization (TLR: 1.6 versus 5.2%; TVR: 2.1 versus 5.9%); and stent thrombosis (definite or probable: 0.5 versus 2.6%). These higher event rates may partly be explained by the higher risks of re-stenosis and repeat revascularization associated with the use of Endeavor as compared to newer-generation DP-DES [ 21 , 22 ], while the very high mortality is related to the old age (80.4 years) in ZEUS participants [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

High Bleeding Risk Patients Treated with Very Thin-Strut Biodegradable Polymer or Thin-Strut Durable Polymer Drug-Eluting Stents in the BIO-RESORT Trial

Zocca

Kok

Heijden

et al. 2018

Cardiovasc Drugs Ther

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PurposePatients with high bleeding risk (HBR) who undergo percutaneous coronary intervention also have an increased risk of ischemic events and represent an overall high-risk population. The coating of durable polymer drug-eluting stents (DP-DES) may induce inflammation and delay arterial healing, which might be reduced by novel biodegradable polymer DES (BP-DES). We aimed to evaluate the safety and efficacy of treating HBR patients with very thin-strut BP-DES versus thin-strut DP-DES.MethodsParticipants in BIO-RESORT (NCT01674803), an investigator-initiated multicenter, randomized all-comers trial, were treated with very thin-strut BP-DES (Synergy or Orsiro) or thin-strut DP-DES (Resolute Integrity). For the present analysis, patients were classified following HBR criteria based on previous trials. The primary endpoint was target vessel failure: a composite of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization at 1 year.ResultsOf all 3514 patients, 1009 (28.7%) had HBR. HBR patients were older (p < 0.001) and had more co-morbidities than non-HBR patients (p < 0.001). At 1-year follow-up, HBR patients had significantly higher rates of target vessel failure (6.7 vs. 4.2%, p = 0.003), cardiac death (1.9 vs. 0.4%, p < 0.001), and major bleeding (3.3 vs. 1.5%, p = 0.001). Of all 1009 HBR patients, 673 (66.7%) received BP-DES and 336 (33.3%) had DP-DES. The primary endpoint was met by 43/673 (6.5%) patients treated with BP-DES and 24/336 (7.3%) treated with DP-DES (HR 0.88 [95%CI 0.54–1.46], p = 0.63). There were no significant between-group differences in the most global patient-oriented clinical endpoint (9.7 vs. 10.5%, HR 0.92 [95%CI 0.61–1.39], p = 0.69) and other secondary endpoints.ConclusionsAt 1-year follow-up, very thin-strut BP-DES showed similar safety and efficacy for treating HBR patients as thin-strut DP-DES.Electronic supplementary materialThe online version of this article (10.1007/s10557-018-6823-9) contains supplementary material, which is available to authorized users.

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“…In contrast to their analysis, this current analysis involved different subgroups of ST with a larger number of randomized patients. Moreover, the study by Li et al was limited to the fact that only two studies reported data on very late ST. Another meta-analysis comparing the efficacy and safety of EES and ZES showed that among randomized trials, ZES and EES were comparable [5]. However, among data obtained from observational studies, EES were associated with significantly lower rates of ST and MACEs compared to ZES.…”

Section: Discussionmentioning

confidence: 99%

“…However, ST in patients treated with Zotarolimus Eluting Stents (ZES) and EES have seldom been analyzed using a large number of randomized patients. Previously published meta-analyses which focused mainly on the general adverse clinical outcomes associated with ZES and EES, did not specifically focus on the different types of ST following PCI [4, 5]. Hence, this current analysis aimed to compare ST associated with ZES versus EES at 1 year follow up, using a large number of patients extracted from randomized trials.…”

Section: Introductionmentioning

confidence: 99%

Comparing Stent Thrombosis associated with Zotarolimus Eluting Stents versus Everolimus Eluting Stents at 1 year follow up: a systematic review and meta-analysis of 6 randomized controlled trials

Bundhun

Yanamala

Huang

2017

BMC Cardiovasc Disord

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BackgroundTwo thousand fifteen has been a winning year for Drug Eluting Stents (DES). Increase in the number of patients with cardiovascular diseases treated by Percutaneous Coronary Intervention (PCI) has resulted to a high demand for second generation DES. This current analysis aimed to compare the different types of Stent Thrombosis (ST) associated with Zotarolimus Eluting Stents (ZES) versus Everolimus Eluting Stents (EES) at 1 year follow up.MethodsElectronic databases were searched for studies comparing ZES with EES. Different types of ST reported at 1 year follow up were considered as the primary endpoints in this analysis. Odds Ratios (OR) with 95% Confidence Intervals (CIs) were used as the statistical parameters and the pooled analyses were carried out by the RevMan 5 · 3 software.ResultsA total number of 10,512 patients were included in this analysis. No significant difference in any definite ST, acute definite ST, subacute definite ST, and late definite ST were observed between ZES and EES, at 1 year follow up with OR: 1.70, 95% CI: 0.92 – 3.16; P = 0.09, OR: 3.44, 95% CI: 0.82 – 14.43; P = 0.09, OR: 1.13, 95% CI: 0.43 – 2.95; P = 0.80 and OR: 2.39, 95% CI: 0.83 – 6.85; P = 0.11 respectively. Moreover, any definite or probable ST and definite/probable/possible ST were also not significantly different with OR: 1.39, 95% CI: 0.89 – 2.17; P = 0.15 and OR: 1.19, 95% CI: 0.84 – 1.70; P = 0.33 respectively. In addition, any probable ST, acute probable ST, late probable ST and possible ST were also not significantly different at 1 year follow up with OR: 1.11, 95% CI: 0.60 – 2.05; P = 0.75, OR: 0.53, 95% CI: 0.12 – 2.40; P = 0.41, OR: 1.67, 95% CI: 0.35 – 7.86; P = 0.52 and OR: 1.08, 95% CI: 0.64 – 1.82; P = 0.78 respectively.ConclusionAt 1 year follow up, ZES were not associated with significantly lower or higher definite and probable ST compared to EES. In addition, no significant difference was observed in acute, subacute and late definite or probable ST. However, further trials are recommended to assess the effects of these second-generation DES during the long-term.

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Safety and efficacy of everolimus-eluting stent versus zotarolimus-eluting stent: A meta-analysis of randomized controlled clinical trials and observational studies

Cited by 7 publications

References 39 publications

Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York

Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York

High Bleeding Risk Patients Treated with Very Thin-Strut Biodegradable Polymer or Thin-Strut Durable Polymer Drug-Eluting Stents in the BIO-RESORT Trial

Comparing Stent Thrombosis associated with Zotarolimus Eluting Stents versus Everolimus Eluting Stents at 1 year follow up: a systematic review and meta-analysis of 6 randomized controlled trials

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