title: Are Everolimus-Eluting Stents Associated With Better Clinical Outcomes Compared to Other Drug-Eluting Stents in Patients With Type 2 Diabetes Mellitus?: A Systematic Review and Meta-Analysis.
abstract: Controversies still exist with the use of Everolimus-Eluting Stents (EES) compared to other Drug-Eluting Stents (DES) in patients with Type 2 Diabetes Mellitus (T2DM). Therefore, in order to solve this issue, we aim to compare the 1-year adverse clinical outcomes between EES and non-EE DES with a larger number of patients with T2DM.Medline, EMBASE, PubMed databases, as well as the Cochrane library were searched for randomized controlled trials (RCTs) and observational studies (OS) comparing EES and non-EE DES in patients with T2DM. One-year adverse outcomes were considered as the clinical endpoints in this study. Odd ratios (OR) with 95% confidence interval (CI) were used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3.Ten studies consisting of a total of 11,981 patients with T2DM (6800 patients in the EES group and 5181 in the non-EE DES group) were included in this meta-analysis. EES were associated with a significantly lower major adverse cardiac events (MACEs) with OR: 0.83, 95% CI: 0.70-0.98, P = 0.03. Revascularization including target vessel revascularization (TVR) and target lesion revascularization (TLR) were also significantly lower in the EES group with OR: 0.62, 95% CI: 0.40-0.94, P = 0.03 and OR: 0.74, 95% CI: 0.57-0.95, P = 0.02, respectively. Also, a significantly lower rate of stent thrombosis with OR: 0.63, 95% CI: 0.46-0.86, P = 0.003 was observed in the EES group. However, a similar mortality rate was reported between the EES and non-EE DES groups.During this 1-year follow-up period, EES were associated with significantly better clinical outcomes compared to non-EE DES in patients suffering from T2DM. However, further research comparing EES with non-EE DES in insulin-treated and noninsulin-treated patients with T2DM are recommended.
authors.affiliation: From the Institute of Cardiovascular Diseases (PKB, M-YL), the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China, and First Affiliated Hospital of Guangxi Medical University (MP, ART), Nanning, Guangxi, China.
authors.forename: Pravesh Kumar
authors.initials: PK
authors.lastname: Bundhun
authors.forename: Manish
authors.initials: M
authors.lastname: Pursun
authors.forename: Abhishek Rishikesh
authors.initials: AR
authors.lastname: Teeluck
authors.forename: Man-Yun
authors.initials: MY
authors.lastname: Long
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D054855:Drug-Eluting Stents / Q000009:adverse effects; D000068338:Everolimus / Q000008:administration & dosage*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus