title: Everolimus-eluting versus sirolimus-eluting stents: a meta-analysis of randomized trials.
abstract: BACKGROUND
  The aim of the study was to compare the outcomes after placement of the everolimus-eluting stent (EES; Xience V) and the sirolimus-eluting stent (SES; Cypher) in patients with coronary artery disease. The second-generation EES is currently one of the most commonly used drug-eluting stents in clinical practice. Although it has clearly been shown superior to paclitaxel-eluting stents, its relative merits against SES have been less extensively assessed.
  
  
  RESULTS
  We identified 5 eligible randomized trials comparing EES with SES in 7370 patients. The primary end point was major adverse cardiac events. Secondary end points were cardiac death, myocardial infarction, repeat revascularization, and the composite of definite and probable stent thrombosis. Overall hazard ratios (HR) and 95% confidence intervals (CI) were calculated for EES versus SES for each of the end points. No heterogeneity across the trials was observed regarding the primary and secondary end points. The risk of major adverse cardiac events (HR, 0.91 [95% CI, 0.77 to 1.08]; P=0.28), cardiac death (HR, 1.02 [95% CI, 0.73 to 1.41]; P=0.92), myocardial infarction (HR, 0.97 [95% CI, 0.66 to 1.35]; P=0.76), repeat revascularization (HR, 0.85 [95% CI, 0.68 to 1.07]; P=0.16), and composite of definite and probable stent thrombosis (HR, 0.79 [95% CI, 0.49 to 1.27], P=0.33) were not significantly different between EES and SES.
  
  
  CONCLUSIONS
  This meta-analysis did not show significant differences between EES and SES in terms of clinical efficacy and safety. Future studies with longer follow-up are needed to better define the relative merits of these drug-eluting stents.
authors.affiliation: Deutsches Herzzentrum and 1 Med Klinik rechts der Isar, Technische Universität, Lazarettstrasse 36, Munich, Germany.
authors.forename: Antoinette
authors.initials: A
authors.lastname: de Waha
authors.forename: Alban
authors.initials: A
authors.lastname: Dibra
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fusaro
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Steffen
authors.initials: S
authors.lastname: Massberg
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D000068338:Everolimus; D006801:Humans; D009203:Myocardial Infarction; D019919:Prosthesis Implantation; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012306:Risk; D020123:Sirolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D013927:Thrombosis; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus