Comparison of sirolimus- and paclitaxel-eluting stents in patients with moderate renal insufficiency: results from the J-DESsERT trial

Otsuka, Masaya; Yokoi, Hiroyoshi; Matsuyama, Yutaka; Hayashi, Yasuhiko; Shiode, Nobuo; Masaoka, Yoshiko; Okimoto, Tomokazu; Tamekiyo, Hiromichi; Kawase, Tomoharu; Yamane, Kunio; Kagawa, Y.; Nakamura, Masato; Muramatsu, Toshiya; Nanto, Shinsuke

doi:10.1016/j.carrev.2014.09.003

Cited by 2 publications

(4 citation statements)

References 15 publications

(20 reference statements)

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“…Otsuka and colleagues demonstrated that the PES group was associated with a lower incidence of 1-year MACE compared with the SES group in dialysis patients, 28) and also reported that there was no significant difference with regard to MACE between PES and SES implantation in patients with moderate to severe renal insufficiency, and the differences between these reports might have been due to the differences in renal insufficiency severity and study population exclusion criteria. 10) Dialysis patients had more complex morphologies such as coronary calcified lesions, and higher incidences of MACE and clinical restenosis after SES implantation, compared to non-dialysis patients. 46,47) Notably, our study indicated that PES implantation had lower TLR than LES implantation in dialysis patients.…”

Section: Discussionmentioning

confidence: 96%

“…Finally, a total of 17 studies including 10,724 patients that met our predefined inclusion criteria were included in this study. [9][10][11][12][15][16][17][23][24][25][26][27][28][29][30][31][32] Study characteristics and quality assessment: The characteristics and overall quality of the individual trials are shown in Table I. Of these 17 studies, 15 were observational retrospective studies 9,12,[15][16][17][23][24][25][26][27][28][29][30][31][32] and 2 were randomized controlled studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…Of these 17 studies, 15 were observational retrospective studies 9,12,[15][16][17][23][24][25][26][27][28][29][30][31][32] and 2 were randomized controlled studies. 10,11) The studies varied in sample size from 68 to 3,201 patients with a follow-up period ranging from 12 months to 47 months. Of these studies, 3 were conducted in the United States, 2 in European countries (1 in Netherlands and 1 in Switzerland), and 12 in Asian countries (8 in Japan and 4 in Korea).…”

Section: Study Selectionmentioning

confidence: 99%

“…Previous studies have shown conflicting results in terms of major cardiac adverse events comparing SES to PES in patients with chronic kidney disease. [9][10][11][12] Newer-generation DES, such as ZES, showed better preserved endothelial-dependent vasomotion and biocompatibility compared to first-generation DES. 13,14) However, even if a second-generation DES is expected to be associated with better clinical outcomes in patients with CKD, data regarding the long-term adverse clinical outcomes treated with either EES/ZES or PES are still controversial.…”

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confidence: 99%

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Comparison of Limus-Eluting and Paclitaxel-Eluting Stents for Coronary Intervention in Patients with Chronic Kidney Disease

et al. 2018

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Chronic kidney disease (CKD) patients have worse adverse cardiovascular outcomes after percutaneous coronary intervention (PCI). Clinical outcomes comparing a limus-eluting stent (LES) to a paclitaxel-eluting stent (PES) in patients with CKD remain controversial. A systematic search was conducted using PubMed, EMBASE, and Cochrane Library. A pooled odds ratio (OR) and 95% confidence interval (CI) were used to calculate original data. We conducted heterogeneity, quality assessment, and publication bias analyses. A total of 17 trials involving 10,724 patients were included. No significant differences were found regarding target vessel revascularization, target lesion revascularization (TLR), stent thrombosis (ST), myocardial infarction (MI), all-cause mortality, and major adverse cardiac events (MACE) between first-generation LES implantation and PES implantation. Second-generation LES implantation was associated with lower rates of allcause mortality (OR, 0.56; 95% CI, 0.39-0.82; P = 0.003), MACE (OR, 0.61; 95% CI, 0.38-0.97; P = 0.04), and ST (OR, 0.45; 95% CI, 0.26-0.77; P = 0.004) compared with PES implantation. In all, the long-term allcause mortality rate was significantly lower after LES implantation than after PES implantation in patients with CKD (OR, 0.78; 95% CI, 0.66-0.93; P = 0.004). However, second-generation LES implantation resulted in a higher rate of TLR (OR, 2.23; 95% CI, 1.53-3.25; P < 0.001) than PES implantation in dialysis patients. In patients with CKD, first-generation LES and PES implantation had comparable mortality and morbidity. Second-generation LES implantation was superior to PES in reducing long-term mortality, MACE, and ST. However, PES may be more effective than LES in dialysis patients.

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Section: Discussionmentioning

confidence: 96%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of Limus-Eluting and Paclitaxel-Eluting Stents for Coronary Intervention in Patients with Chronic Kidney Disease

et al. 2018

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Is There Any Significant Difference in Stent Thrombosis Between Sirolimus and Paclitaxel Eluting Stents?

Bundhun

Chen

2016

Medicine

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Several meta-analyses have shown no significant difference in stent thrombosis (ST) between sirolimus eluting stents (SES) and paclitaxel eluting stents (PES). However, other meta-analyses have found SES to be superior to PES. Therefore, to solve this issue, we aim to compare the clinical outcomes between SES and PES during a follow-up period of about 1 or more years.We have searched Medline and EMBASE for randomized controlled trials (RCTs) comparing SES with PES. These RCTs have been carefully analyzed and then different types of ST including ST defined by the Academic Research Consortium (ARC), acute ST, late and very late ST have all been considered as the clinical endpoints in this study. A follow-up period of about 1 year, between 1 and 2 years as well as a longer follow-up period between 1 and 5 years have been considered. Data were retrieved and combined by means of a fixed-effect model because of a lower heterogeneity observed among the results. Odd ratios (OR) and 95% confidence intervals (CIs) were calculated and the pooled analyses were performed with RevMan 5.3 software.Twenty-nine studies from 19 RCTs comprising of 16,724 patients (8115 patients in the SES group and 8609 patients in the PES group) satisfied the inclusion criteria and were included in this meta-analysis. No significant differences in ST have been observed between SES and PES. Results were as follow: definite ST with OR: 0.87; 95% CI: 0.64–1.18, P = 0.36; probable ST with OR:0.72; 95% CI: 0.42–1.21, P = 0.21; definite, probable and/or possible ST with OR: 0.94; 95% CI: 0.75–1.17, P = 0.57; acute ST with OR: 0.99; 95% CI: 0.38–2.56, P = 0.98; subacute ST with OR: 0.72; 95% CI: 0.41–1.25, P = 0.25; early ST with OR: 0.81; 95% CI: 0.53–1.25, P = 0.34; late ST with OR: 0.72; 95% CI: 0.39–1.34, P = 0.30; very late ST with OR: 1.02; 95% CI: 0.72–1.44, P = 0.92; and any ST with OR: 0.86; 95% CI: 0.69–1.07, P = 0.18. Long-term ST between 1 and 5 years with OR: 0.93; 95% CI: 0.71–1.22, P = 0.60 was also not significantly different.No significant difference in ST has been observed between patients treated with either SES or PES. Hence SES and PES can both be considered almost equally effective.

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Comparison of sirolimus- and paclitaxel-eluting stents in patients with moderate renal insufficiency: results from the J-DESsERT trial

Cited by 2 publications

References 15 publications

Comparison of Limus-Eluting and Paclitaxel-Eluting Stents for Coronary Intervention in Patients with Chronic Kidney Disease

Comparison of Limus-Eluting and Paclitaxel-Eluting Stents for Coronary Intervention in Patients with Chronic Kidney Disease

Is There Any Significant Difference in Stent Thrombosis Between Sirolimus and Paclitaxel Eluting Stents?

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