Sirolimus-eluting stents showed no significant difference in total mortality compared to bare metal stents (4.1% vs 3.2%, P=0.37) at a mean follow-up of 2.6 years.
Meta-Analysis (n=1,748)
Double-blind
Randomized
Yes
Does a sirolimus-eluting stent reduce or increase total and cardiac mortality compared to a bare metal stent in patients with a single de novo coronary stenosis?
In patients undergoing percutaneous coronary intervention for a single de novo stenosis, the use of sirolimus-eluting stents does not significantly increase long-term total or cardiac mortality compared to bare metal stents.
Absolute Event Rate: 4.1% vs 3.2%
p-value: p=0.37
AIMS: Although drug-eluting stents have assumed a dominant role in interventional cardiology, concern has been raised about the potential for long-term adverse outcomes, including death. The aim of the present study was to compare the incidence and cause of death between patients who received sirolimus-eluting or bare metal stents. METHODS AND RESULTS: An integrated analysis was performed on 1748 patients enrolled in four prospective double-blind trials that randomly assigned patients to receive either a sirolimus-eluting or a bare metal stent for treatment of a single de novo coronary stenosis. During a mean follow-up of 2.6+/-0.6 years, 64 patients (3.7%) died. Total mortality was 3.2% among 870 bare metal stent patients and 4.1% among 878 sirolimus-eluting stent patients (P=0.37); there was no difference in cardiac mortality (1.4 vs. 1.3%; P=0.55) or causes of death between these two groups. The predominant cause of death was non-cardiac. Cardiac death was most frequently assigned owing to unwitnessed death. Death due to acute myocardial infarction, congestive heart failure, and stent thrombosis occurred infrequently. CONCLUSION: At a mean follow-up of 2.6 years in percutaneous coronary intervention patients, the predominant cause of death was non-cardiac. There was no significant difference in either the frequency or the cause of death with implantation of either sirolimus-eluting or bare metal stents.
Holmes et al. (Mon,) conducted a meta-analysis in Single de novo coronary stenosis (n=1,748). Sirolimus-eluting stent vs. Bare metal stent was evaluated on Total mortality (p=0.37). Sirolimus-eluting stents showed no significant difference in total mortality compared to bare metal stents (4.1% vs 3.2%, P=0.37) at a mean follow-up of 2.6 years.