title: Everolimus-eluting versus sirolimus-eluting stents: an updated meta-analysis of randomized trials.
abstract: BACKGROUND
  Everolimus-eluting stents (EES; Xience V) are among the most commonly used newer generation drug-eluting stents in clinical practice and have clearly proven superiority over paclitaxel-eluting stents. Nevertheless, the relative merits of EES against the previous gold-standard sirolimus-eluting stent (SES; Cypher) have been less extensively assessed. We aimed to compare the clinical outcomes of EES with SES in patients with coronary artery disease undergoing percutaneous coronary intervention.
  
  
  RESULTS
  We identified eight eligible randomized trials comparing EES with SES including 11,167 patients. The primary endpoint was the incidence of major adverse cardiac events (MACE). Secondary endpoints were target lesion revascularization (TLR) and the composite of definite and probable stent thrombosis. The follow-up ranged from 9 to 36 months. No heterogeneity across the trials was observed regarding the selected endpoints. There was no difference in risk of MACE (HR 0.91 [0.79-1.04]; p = 0.15), TLR (HR 0.86 [0.72-1.04]; p = 0.12) and the composite of definite and probable stent thrombosis (HR 0.84 [0.54-1.29], p = 0.42). The risk of definite stent thrombosis was significantly lower in patients receiving EES (HR 0.49 [0.27 to 0.91]; p = 0.02).
  
  
  CONCLUSIONS
  Using the largest available dataset of patients treated in randomized trials, the present meta-analysis demonstrated that the use of EES versus SES was associated with comparable incidence of overall clinical events. However, EES may be associated with a lower risk of definite stent thrombosis.
authors.affiliation: Deutsches Herzzentrum and 1. Med. Klinik, Klinikum rechts der Isar, Technische Universität, Lazarettstr. 36, 80636 Munich, Germany. dewaha@dhm.mhn.de
authors.forename: Antoinette
authors.initials: A
authors.lastname: de Waha
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cassese
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.forename: Lamin A
authors.initials: LA
authors.lastname: King
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D000068338:Everolimus; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus