title: Paclitaxel-eluting stents versus sirolimus-eluting stents in patients with diabetes mellitus undergoing percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials.
abstract: Uncertainties exist with regard to the efficacy of paclitaxel-eluting stents (PES) versus sirolimus-eluting stents (SES) in diabetes patients undergoing percutaneous coronary intervention (PCI). We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the outcome of PES versus SES in diabetes patients undergoing PCI. A literature search was started, and we found all studies conducted from 2005 to 2016. We systematically searched the literature through the MEDLINE, Cochrane library, and EMBASE. Quality assessments were evaluated with the Jadad scale. Data were extracted considering the characteristics of efficacy and the safety of the designs. 12 RCTs satisfy the inclusion criteria. There is a significant decrease of target lesion revascularization (TLR) (MD = 0.65, 95 % CI = 0.42-1.00, P = 0.05) in a year and more than 1 year (MD = 0.54, 95 % CI = 0.37-0.78, P = 0.00010). A significant decrease of target vessel revascularization (TVR) in more than 1 year is (MD = 0.62, 95 % CI = 0.47-0.81, P = 0.0004). A significant decrease of major adverse cardiac events (MACE) in more than 1 year is (MD = 0.73, 95 % CI = 0.60-0.89, P = 0.002). Nevertheless, there is no significant difference in mortality (MD = 0.85, 95 % CI = 0.66-1.11, P = 0.24), stent thrombosis (ST) (MD = 0.65, 95 % CI = 0.35-1.21, P = 0.18), or myocardial infarction (MD = 1.04, 95 % CI = 0.71-1.51, P = 0.84). SES may be more significant in decreasing TLR, TVR, and MACE than PES without significantly increasing mortality, ST and MI in diabetes patients.
authors.affiliation: Department of Cardiology, The First College of Clinical Medical Sciences, Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, 443000, Hubei, China.
authors.forename: Hui-Bo
authors.initials: HB
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First College of Clinical Medical Sciences, Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, 443000, Hubei, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zeng
authors.affiliation: Department of Cardiology, The First College of Clinical Medical Sciences, Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, 443000, Hubei, China. yangjun@ctgu.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Cardiology, The First College of Clinical Medical Sciences, Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, 443000, Hubei, China. yangjian@ctgu.edu.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Cardiology, The First College of Clinical Medical Sciences, Institute of Cardiovascular Diseases, China Three Gorges University, Yichang, 443000, Hubei, China.
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Liu
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy*; D017052:Hospital Mortality; D006801:Humans; D017239:Paclitaxel / Q000494:pharmacology / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D020123:Sirolimus / Q000494:pharmacology / Q000627:therapeutic use; D015607:Stents / Q000592:standards* / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel; D020123:Sirolimus
keywords: Diabetes mellitus; Eluting stent; Meta-analysis; Outcomes; Percutaneous coronary intervention