Key result
Zotarolimus-eluting stents significantly reduced the long-term risk of definite or probable stent thrombosis (RR 1.91) and myocardial infarction compared to sirolimus- and paclitaxel-eluting stents.
Why the study?
Do Zotarolimus Eluting Stents (ZES) reduce long-term adverse clinical outcomes compared to SES, PES, and EES in patients undergoing Percutaneous Coronary Intervention?
Meta-Analysis (n=17,606)
Do Zotarolimus Eluting Stents (ZES) reduce long-term adverse clinical outcomes compared to SES, PES, and EES in patients undergoing Percutaneous Coronary Intervention?
Relative Risk: 1.91 (95% CI 1.33–2.75)
Number Needed to Treat: 140
p-value: p=0.0004
In long-term follow-up (2-5 years), ZES showed similar adverse outcomes to EES, but significantly lower rates of MI and stent thrombosis compared to SES and PES.
ZES linked to lower long-term MI and ST versus SES/PES but similar to EES; leaves open preference pending prospective confirmation.
Several previously published trials comparing Zotarolimus Eluting Stents (ZES) with Sirolimus Eluting Stents (SES), Paclitaxel Eluting Stents (PES) or Everolimus Eluting Stents (EES) at a follow up period of 1 year, were continually being followed up in order to assess the long-term outcomes. In this meta-analysis, we aimed to compare the long-term (2-5 years) adverse clinical outcomes which were associated with ZES versus SES, PES and EES following Percutaneous Coronary Intervention (PCI). Risk Ratios (RR) with 95% Confidence Intervals (CIs) were generated and the analysis was carried out by the RevMan 5.3 software. In this analysis with a total number of 17,606 participants, ZES and EES were associated with similar adverse outcomes including Stent Thrombosis (ST), myocardial infarction (MI), major adverse cardiac events and repeated revascularization. When ZES were compared with SES and PES during the long-term, MI and definite or probable ST were significantly lower with ZES, with RR: 1.35, 95% CI: 1.17-1.56; P = 0.0001 and RR: 1.91, 95% CI: 1.33-2.75; P = 0.0004 respectively whereas the other adverse outcomes were similarly manifested. Future research should be able to confirm this hypothesis.
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Bundhun et al. (2017) conducted a meta-analysis in Coronary artery disease (n=17,606). Zotarolimus Eluting Stents (ZES) vs. Sirolimus Eluting Stents (SES), Paclitaxel Eluting Stents (PES), and Everolimus Eluting Stents (EES) was evaluated on Definite or probable stent thrombosis (RR 1.91, 95% CI 1.33-2.75, p=0.0004). Zotarolimus-eluting stents significantly reduced the long-term risk of definite or probable stent thrombosis (RR 1.91) and myocardial infarction compared to sirolimus- and paclitaxel-eluting stents.
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