title: Direct and indirect comparison meta-analysis demonstrates the superiority of sirolimus- versus paclitaxel-eluting stents across 5854 patients.
abstract: There is ongoing debate to identify the most effective, safe and cost-beneficial drug-eluting stent, between the two currently approved and used devices, i.e. sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES). To date, head-to-head comparison studies of SES vs PES have been however limited by relatively small sample sizes and the low number of events typically associated with these highly effective coronary devices. To overcome the drawbacks of single trials, direct and indirect comparison meta-analyses have been designed and conducted to thoroughly compare sirolimus- vs paclitaxel eluting-stents. This article provides results of a pooled analysis of such indirect and direct comparisons, definitively demonstrating across 5854 patients the superiority of SES in comparison to PES (odds ratio 0.62 [95% confidence interval 0.50-0.75], p<0.0001 for binary angiographic restenosis, and odds ratio 0.66 [0.52-0.84], p=0.0008 for target lesion revascularization). Indeed, such combination of direct and indirect comparisons should also be envisaged to soundly and timely appraise the next generation of drug-eluting stents.
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: Marzia
authors.initials: M
authors.lastname: Lotrionte
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Luca
authors.initials: L
authors.lastname: Testa
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D016503:Drug Delivery Systems; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
chemical_list: D017239:Paclitaxel; D020123:Sirolimus