title: Efficacy and safety of limus-eluting versus paclitaxel-eluting coronary artery stents in patients with diabetes mellitus: A meta-analysis.
abstract: OBJECTIVE
  The relative efficacy and safety of limus-eluting stent (LES) versus paclitaxel-eluting stent (PES) in DM patients remain unclear.
  
  
  METHODS
  The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials electronic databases were searched from January 2001 to December 2013. Clinical trials that performed head-to-head comparisons of LES versus PES implantation in patients with DM were considered for inclusion.
  
  
  RESULTS
  This meta-analysis included 28 clinical trials involving 23,678 patients: 9953 who underwent sirolimus-eluting stent (SES) implantation, 4209 underwent everolimus-eluting stent (EES) or zotarolimus-eluting stent (ZES) implantation, and 9516 underwent PES implantation. The short-term target lesion revascularization (TLR) rate was significantly lower after SES implantation than after PES implantation (3.6% vs 6.3%; odds ratio (OR): 0.659; P=0.014), but there were no significant differences in the rates of target vessel revascularization (TVR), stent thrombosis (ST), myocardial infarction (MI), all-cause mortality, or major adverse cardiac events (MACE). There were no differences in the longer-term rates of TLR, TVR, ST, MI, all-cause mortality, or MACE between SES versus PES. Second-generation LES (EES or ZES) implantation resulted in lower rates of ST (2.1% vs 3.3%; OR: 0.586; P<0.001), MI (2.3% vs 4.1%; OR: 0.527; P=0.001), and MACE (8.0% vs 10.3%; OR: 0.796; P=0.007) than PES implantation.
  
  
  CONCLUSIONS
  In patients with DM, short- and longer-term MACE rates were similar after first-generation LES and PES implantation. The second-generation LES may be better than PES implantation in rates of ST, MI, and MACE.
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yuqi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Tianjin Chest Hospital, Tianjin, China.
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Chen
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Xue
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Jinwen
authors.initials: J
authors.lastname: Tian
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Cardiology department, Chinese PLA General Hospital, Beijing, China. Electronic address: ametuofo4290@gmail.com.
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D011474:Prosthesis Design / Q000379:methods; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel
keywords: Diabetes mellitus; Eluting stent; Meta-analysis; Percutaneous coronary intervention