title: Long-term clinical outcomes of everolimus-eluting stent versus paclitaxel-eluting stent in patients undergoing percutaneous coronary interventions: a meta-analysis.
abstract: BACKGROUND
  Everolimus -eluting stent (EES) is common used in patients undergoing percutaneous coronary interventions (PCI). Our purpose is to evaluate long-term clinical outcomes of everolimus -eluting stent (EES) versus paclitaxel-eluting stent (PES) in patients undergoing percutaneous coronaryinterventions (PCI) in randomized controlled trials (RCTs).
  
  
  METHODS
  We searched Medline, EMBASE, Cochrane Library, CNKI, VIP and relevant websites ( https://scholar-google-com.ezproxy.lib.usf.edu/ ) for articles to compare outcomes between everolimus-eluting stent and paclitaxel-eluting stent without language or date restriction. RCTs that compared the use of everolimus -eluting stent and paclitaxel-eluting stent in PCI were included. Variables relating to patient, study characteristics, and clinical endpoints were extracted. Meta-analysis was performed using RevMan 5.2 software.
  
  
  RESULTS
  We identified 6 published studies (from three randomized trials) more on everolimus-eluting stent (n = 3352) than paclitaxel-eluting (n = 1639), with follow-up duration ranging from 3, 4 and 5 years. Three-year outcomes of everolimus-eluting stent compared to paclitaxel-eluting were as following: the everolimus-eluting stent significantly reduced all-cause death (relative risk [RR]:0.63; 95% confidence interval [CI]: 0.46. to 0.82), MACE (RR: 0.56; 95% CI: 0.41 to 0.77), MI (RR: 0.64; 95% CI: 0.48 to 0.86), TLR (RR: 0.72; 95% CI: 0.59 to 0.88), ID-TLR (RR: 0.74; 95% CI: 0.59 to 0.92) and ST (RR: 0.54; 95% CI: 0.32 to 0.90). There was no difference in TVR between the everolimus-eluting and paclitaxel-eluting (RR: 0.76; 95% CI: 0.58 to 1.10); Four-year outcomes of everolimus-eluting compared to paclitaxel-eluting: the everolimus-eluting significantly reduced MACE (RR: 0.44; 95% CI: 0.18 to 0.98) and ID-TLR (RR: 0.47; 95 % CI: 0.23 to 0.97). There was no difference in MI (RR: 0.48; 95% CI: 0.16 to 1.46), TLR (RR: 0.46; 95% CI: 0.20 to 1.04) and ST ((RR: 0.34; 95% CI: 0.05 to 2.39). Five-year outcomes of everolimus-eluting stent compared to paclitaxel-eluting: There was no difference in ID-TLR (RR: 0.67; 95% CI: 0.45 to 1.02) and ST (RR: 0.71; 95% CI: 0.28 to 1.80).
  
  
  CONCLUSIONS
  In the present meta-analysis, everolimus-eluting appeared to be safe and clinically effective in patients undergoing PCI in comparison to PES in 3-year clinical outcomes; there was similar no difference in reduction of ST between EES and PES in long-term(≥ 4 years) clinical follow-ups. Everolimus-eluting is more safety than paclitaxel-eluting in long-term clinical follow-ups, whether these effects can be applied to different patient subgroups warrants further investigation.
authors: Department of Pharmacy, Gansu Provincial Hospital, Donggang West Road No. 204, Lanzhou, Gansu, 730000, China. bianshishengfeng@163.com.
authors: Min
authors: M
authors: Meng
authors: Department of Pharmacy, Gansu Provincial Hospital, Donggang West Road No. 204, Lanzhou, Gansu, 730000, China. 22197282@qq.com.
authors: Bei
authors: B
authors: Gao
authors: Department of Pharmacy, Gansu Provincial Hospital, Donggang West Road No. 204, Lanzhou, Gansu, 730000, China. 409790443@qq.com.
authors: Xia
authors: X
authors: Wang
authors: Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, 730000, China. 23137932@qq.com.
authors: Zheng-gang
authors: ZG
authors: Bai
authors: Department of Pharmacy, Gansu Provincial Hospital, Donggang West Road No. 204, Lanzhou, Gansu, 730000, China. 285365964@qq.com.
authors: Ri-Na
authors: RN
authors: Sa
authors: Department of Pharmacy, Gansu Provincial Hospital, Donggang West Road No. 204, Lanzhou, Gansu, 730000, China. 550313937@qq.com.
authors: Bin
authors: B
authors: Ge
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D023903:Coronary Restenosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology; D017239:Paclitaxel / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus; D017239:Paclitaxel