The impact of everolimus versus other rapamycin derivative-eluting stents on clinical outcomes in patients with coronary artery disease: A meta-analysis of 16 randomized trials

Zhang, Yaojun; Zhu, Liping; Bourantas, Christos V.; Iqbal, Javaid; Dong, Shengjie; Campos, Carlos M.; Li, Minghui; Ye, Fei; Tian, Nai‐Liang; García‐García, Héctor M.; Serruys, Patrick W.

doi:10.1016/j.jjcc.2014.01.007

Cited by 14 publications

(10 citation statements)

References 49 publications

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“…[ 16 ] A pooled analysis from the SPIRIT II, III, IV, and COMPARE trials also showed that EES significantly reduced composite endpoint of cardiac death/MI/ischemia-driven target lesion revascularization compared with the old generation DES. [ 6 ] In this analysis, we demonstrated a consistent low risk of ST, TVF, and NACE in patients following EES implantation at 2-year follow-up.…”

Section: Discussionsupporting

confidence: 54%

“…or biodegradable polymers offer better safety outcomes. [ 6 ] The “all-comers” COMPARE (Comparison of the everolimus eluting XIENCE-V stent with the paclitaxel eluting TAXUS LIBERTE stent in all-comers: a randomized open label trial) trial showed EES was associated with a significant reduction in definite/probable ST compared with paclitaxel-eluting stent (0.6% vs. 2.5%, P < 0.001) at 2 years follow-up. [ 15 ] Recently, a large registry study found that EES had a lower risk of very late ST (2.0%) than sirolimus-eluting stent (2.8%, P = 0.05) and paclitaxel-eluting stent (4.0%, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 4 ] New generation DES with biocompatible or biodegradable polymers has significantly improved clinical safety and efficacy. [ 5 6 7 ] Although 6 months DAPT use for patients who underwent new generation DES implantation has been recommended in recent guidelines,[ 8 ] the optimal duration of DAPT use has not been fully defined.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation

Zhang

Zhao

et al. 2015

Chinese Medical Journal

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Background:Studies have suggested that use of prolonged dual antiplatelet therapy (DAPT) following new generation drug-eluting stent implantation may increase costs and potential bleeding events. This study aimed to investigate the association of DAPT status with clinical safety in patients undergoing everolimus-eluting stent (EES) implantation in the SEEDS study (A Registry to Evaluate Safety and Effectiveness of Everolimus Drug-eluting Stent for Coronary Revascularization) at 2-year follow-up.Methods:The SEEDS study is a prospective, multicenter study, where patients (n = 1900) with small vessel, long lesion, or multi-vessel diseases underwent EES implantation. Detailed DAPT status was collected at baseline, 6-month, 1- and 2-year. DAPT interruption was defined as any interruption of aspirin and/or clopidogrel more than 14 days. The net adverse clinical events (NACE, a composite endpoint of all-cause death, all myocardial infarction (MI), stroke, definite/probable stent thrombosis (ST), and major bleeding (Bleeding Academic Research Consortium II-V)) were investigated according to the DAPT status at 2-year follow-up.Results:DAPT was used in 97.8% of patients at 6 months, 69.5% at 12 months and 35.4% at 2 years. It was observed that the incidence of NACE was low (8.1%) at 2 years follow-up, especially its components of all-cause death (0.9%), stroke (1.1%), and definite/probable ST (0.7%). DAPT was not an independent predictor of composite endpoint of all-cause death/MI/stroke (hazard ratio [HR]: 0.693, 95% confidence interval [CI]: 0.096–4.980, P = 0.715) and NACE (HR: 1.041, 95% CI: 0.145–7.454, P = 0.968). Of 73 patients who had DAPT interruption, no patient had ST at 12-month, and only 1 patient experienced ST between 1- and 2-year (1.4%). There was a high frequency of major bleeding events (53/65, 82.5%) occurred in patients receiving DAPT treatment.Conclusions:Prolonged DAPT use was not associated with improved clinical safety. The study emphasized that duration of DAPT needs to be shortened in Chinese patients following EES implantation (ClinicalTrials.gov identifier: NCT 01157455).

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation

Zhang

Zhao

et al. 2015

Chinese Medical Journal

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“…Heavy calcification, another big challenge to the operator, increases the likelihood of procedural failure and complications in coronary intervention. [ 19 , 20 ] In the present study, 75 (37%) of 188 complex cases involved heavy calcification lesions and were completed successfully. Rotational atherectomy was used through radial artery access in 2 cases; the 1.25 and 1.5 mm burr can be used through the 6F catheter thereby easily achieving plaque modification in most cases.…”

Section: Discussionmentioning

confidence: 61%

The safety and feasibility of guidezilla catheter in complex coronary interventions and an observational study

Hou²,

Qian³

et al. 2017

Medicine

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The monorail GuidezillaTM guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications.The Guidezilla catheter was used most commonly in PCI of CTOs (45%) and heavy proximal calcification (37%), followed by tortuosity (10%), previously deployed proximal stents (4%), and coronary artery anomaly (4%). The right coronary artery (48%) was most commonly intervened followed by the left ascending (35%) and left circumflex (17%) arteries. Rates of target lesion crossing success and procedural success were both 99%, with one device-related periprocedural complication, namely proximal vessel dissection secondary to deep insertion which was successfully treated with stent implantation. Ninety percent of PCI were performed and completed successfully by radial access.In a single center with experienced operators, the use of the Guidezilla guide extension catheter in PCI of complex coronary anatomy performed mostly via radial artery access appeared safe and efficacious, and greatly facilitated device delivery.

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“…One of the biggest differences between studied devices is the type of antiproliferative drug eluted from the stent surface (sirolimus vs. everolimus). Safety data from large meta-analysis favor the use of everolimus vs. sirolimus eluting stents [38]. However, most of the differences in device performance are explained by the type and design of metallic platforms or polymers used in these devices.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of biodegradable polymer-coated thin strut sirolimus-eluting stent vs. durable polymer-coated everolimus-eluting stent in patients with acute myocardial infarction

Gierlotka

Szczurek-Katański

Osuch

et al. 2018

pwki

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IntroductionThe biodegradable polymer drug-eluting stents were developed to improve vascular healing. However, further data are needed to confirm the safety and efficacy of these stents in patients with acute myocardial infarction (AMI).AimWe sought to determine the 1-year clinical follow-up in patients with AMI treated with a thin strut biodegradable polymer-coated sirolimus-eluting stent (BP-SES) versus a durable coating everolimus-eluting stent (DP-EES).Material and methodsWe analyzed patients with AMI (STEMI and NSTEMI) treated with either a BP-SES (ALEX, Balton, Poland, n = 886) or DP-EES (XIENCE, Abbott, USA, n = 1054) with available 1-year clinical follow-up using propensity score matching. Outcomes included target vessel revascularization (TVR) as the efficacy outcome and all-cause death, myocardial infarction, and definite/probable stent thrombosis as safety outcomes.ResultsAfter propensity score matching 672 patients treated with BP-SES and 672 patients treated with DP-EES were selected. Procedural and clinical characteristics were similar between the groups. In-hospital mortality was similar in both tested groups. One-year follow-up demonstrated comparable efficacy outcome TVR (BP-SES 7.1% vs. DP-EES 5.2%, p = 0.14), as well as similar safety outcomes of all-cause death, myocardial infarction, and definite/probable stent thrombosis.ConclusionsThe thin-strut biodegradable polymer coated sirolimus-eluting stent demonstrated comparable clinical outcomes at 1 year after implantation to the DP-EES. These data support the relative safety and efficacy of BP-SES in AMI patients undergoing percutaneous coronary intervention.

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The impact of everolimus versus other rapamycin derivative-eluting stents on clinical outcomes in patients with coronary artery disease: A meta-analysis of 16 randomized trials

Cited by 14 publications

References 49 publications

Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation

Clinical Impact of Dual Antiplatelet Therapy Use in Patients Following Everolimus-eluting Stent Implantation

The safety and feasibility of guidezilla catheter in complex coronary interventions and an observational study

Safety and efficacy of biodegradable polymer-coated thin strut sirolimus-eluting stent vs. durable polymer-coated everolimus-eluting stent in patients with acute myocardial infarction

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