A meta-analysis of clinical trials of paclitaxel- and sirolimus-eluting stents in patients with obstructive coronary artery disease.
OBJECTIVE
This meta-analysis was conducted to compare the effects of drug (paclitaxel and sirolimus)-eluting stents with bare metal stents on major adverse cardiac events, restenosis rates and late loss of arterial lumen diameter in patients with obstructive coronary artery disease.


METHODS
Randomized, controlled clinical trials comparing sirolimus- and paclitaxel-eluting stents with bare metal stents were identified through electronic and manual search. Fixed effects method of Mantel-Haenszel and random effects method of DerSimonian and Laird were used for computing the pooled odds ratio (OR) and 95% confidence intervals (CI) for major adverse cardiac events and restenosis rates. Standardized mean difference with 95% CI was calculated for late-loss of arterial lumen diameter.


RESULTS
A total of 13 studies were included in the meta-analysis. As compared with bare metal stents, the use of sirolimus- and paclitaxel-eluting stents significantly reduced the major adverse cardiac events (pooled OR 0.35; 95% CI 0.24-0.50), restenosis rates (pooled OR 0.27; 95% CI 0.15-0.47), and late loss of arterial lumen diameter (mean difference 0.57 mm, 95% CI 0.49-0.68).


CONCLUSIONS
Paclitaxel- and sirolimus-eluting stents significantly reduced the incidence of major adverse cardiac events, restenosis rates, and late loss of arterial lumen diameter as compared with bare metal stents.
Shafiq
N
N
Department of Pharmacology 2, Postgraduate Institute of Medical Education & Research, Chandigarh-160 012, India. ppandhi17@hotmail.com
Malhotra
S
S
Pandhi
P
P
Grover
A
A
Uboweja
A
A
D049109:Cell Proliferation / Q000187:drug effects; D023903:Coronary Restenosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D023921:Coronary Stenosis / Q000188:drug therapy* / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004343:Drug Implants; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology
D004343:Drug Implants; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus