A Meta-Analysis of 16 Randomized Trials of Sirolimus-Eluting Stents Versus Paclitaxel-Eluting Stents in Patients With Coronary Artery Disease
Albert Schömig, MD*,*,
Alban Dibra, MD*,
Stephan Windecker, MD ,
Julinda Mehilli, MD*,
José Suárez de Lezo, MD ,
Christoph Kaiser, MD ,
Seung-Jung Park, MD||,
Jean-Jacque Goy, MD,
Jae-Hwan Lee, MD¶,
Emilio Di Lorenzo, MD#,
Jinjin Wu, MD*,
Peter Jüni, MD**,
Matthias E. Pfisterer, MD,
Bernhard Meier, MD and
Adnan Kastrati, MD*
* Deutsches Herzzentrum, Technische Universität, Munich, Germany
Department of Cardiology, University Hospital Bern, Bern, Switzerland
Reina Sofia Hospital, University of Córdoba, Córdoba, Spain
University of Basel, Basel, Switzerland
|| Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
¶ Cardiovascular Center in Chungnam National University Hospital, Daejeon, Korea
# A.O.R.N. "S. G. Moscati," Avellino, Italy
** Department of Social and Preventive Medicine, University Hospital Bern, Bern, Switzerland
Service of Cardiology, Clinique Cecil, Lausanne, Switzerland
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Figure 1 Analysis of Reintervention According to the Drug-Eluting Stent Type
(A) Absolute numbers of patients requiring reintervention and hazard ratios (HRs) for this end point with sirolimus-eluting stent (SES) versus paclitaxel-eluting stent (PES) for individual trials and pooled population. The HRs are shown on a logarithmic scale. The size of the square is proportional to the weight of the individual studies, measured as the inverse of the estimated variance of the log HR. (B) Kaplan-Meier curves of reintervention in each of the stent groups for the pooled population. Hazard ratio indicates the HR associated with the SES. BASKET = Basel Stent Kosten Effektivitäts Trial; CI = confidence interval; CORPAL = Drug-Eluting Stents for Complex Lesions: Randomized Rapamycin Versus Paclitaxel trial; ISAR-DESIRE = Intracoronary Stenting and Angiographic Results: Drug-Eluting Stents for In-Stent Restenosis trial; ISAR-DIABETES = Intracoronary Stenting and Angiographic Results: Do Diabetic Patients Derive Similar Benefit From Paclitaxel-Eluting and Sirolimus-Eluting Stents trial; ISAR-SMART 3 = Drug-Eluting Stenting to Abrogate Restenosis in Small Arteries Trial; LONG DES II = Randomized Comparison of the Efficacy of Sirolimus-Eluting Stent Versus Paclitaxel-Eluting Stent in the Treatment of Long Native Coronary Lesions trial; PROSIT = Prospective Randomized Trial of Sirolimus- versus Paclitaxel-Eluting Stents for the Treatment of Acute ST-Elevation Myocardial Infarction; REALITY = Prospective, Randomized, Multi-Center Comparison of the Cypher Sirolimus-Eluting and the Taxus Paclitaxel-Eluting Stent Systems trial; SIRTAX = Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization trial; SORT OUT II = Prospective, Multicenter, Large-Scale, Randomized Trial of Paclitaxel- and Sirolimus-Eluting Stents in "Real-World" Lesions trial; TAXI = Prospective Randomized Comparison Between Paclitaxel and Sirolimus Stents in the Real World of Interventional Cardiology trial.
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Figure 2 Analysis of Stent Thrombosis According to the Drug-Eluting Stent Type
(A) Absolute numbers of patients with stent thrombosis and HRs for stent thrombosis associated with SES versus PES for individual trials and pooled population. The HRs are shown on a logarithmic scale. The size of the square is proportional to the weight of the individual studies, measured as the inverse of the estimated variance of the log HR. (B) Kaplan-Meier curves of stent thrombosis in the pooled population according to stent type. Abbreviations as in Figure 1.
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Figure 3 Analysis of Mortality According to the Drug-Eluting Stent Type
(A) Absolute numbers of patients experiencing death and HRs for death associated with SES versus PES for individual trials and pooled population. The HRs are shown on a logarithmic scale. The size of the square is proportional to the weight of the individual studies, measured as the inverse of the estimated variance of the log HR. (B) Kaplan-Meier curves of mortality in each of the stent groups for the pooled population. Abbreviations as in Figure 1.
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Figure 4 Analysis of Myocardial Infarction According to the Drug-Eluting Stent Type
(A) Absolute numbers of patients experiencing myocardial infarction associated with SES versus PES for individual trials and pooled population. The HRs are shown on a logarithmic scale. The size of the square is proportional to the weight of the individual studies, measured as the inverse of the estimated variance of the log HR. (B) Kaplan-Meier curves of myocardial infarction in each of the stent groups for the pooled population. Abbreviations as in Figure 1.
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