Key result
Everolimus-eluting stents were associated with lower target vessel revascularization (adjusted HR 0.40; 95% CI 0.22-0.75; P=0.004) compared to first-generation drug-eluting stents at 2 years.
Why the study?
Do everolimus-eluting stents reduce stent thrombosis and target vessel revascularization in patients undergoing percutaneous coronary intervention compared to first-generation drug-eluting stents?
Cohort (n=2,126)
Do everolimus-eluting stents reduce stent thrombosis and target vessel revascularization in patients undergoing percutaneous coronary intervention compared to first-generation drug-eluting stents?
Hazard Ratio: 0.4 (95% CI 0.22–0.75)
Absolute Event Rate: 3.8% vs 7.2%
p-value: p=0.004
Everolimus-eluting stents are associated with reduced target vessel revascularization and a trend toward lower stent thrombosis at 2 years compared to first-generation drug-eluting stents in patients undergoing PCI.
May reduce target vessel revascularization in observational PCI data; leaves open effects on stent thrombosis and need for randomized confirmation.
OBJECTIVES: We sought to compare the safety and effectiveness of everolimus-eluting stents (EES) versus first generation drug-eluting stents (FG-DES; sirolimus-eluting stent [SES] or paclitaxel-eluting stent [PES]). METHODS: In 2,126 patients undergoing percutaneous coronary intervention (PCI), we compared the 2-year incidence of stent thrombosis (ST) and target vessel revascularization (TVR) between the EES versus FG-DES groups. Secondary end-points included all-cause death, myocardial infarction (MI), death or MI, and major adverse cardiovascular events (MACE, including death, MI, ST, or TVR). Further, we evaluated these end-points in 2 propensity-matched subgroups: EES versus SES; EES versus PES. RESULTS: Complete 2-year follow-up was available in 1,911 (90%) patients. Compared to FG-DES, implantation of EES was associated with trends towards lower ST (0.9% vs. 2.8%, P = 0.068) and TVR (3.8% vs. 7.2%, P = 0.052), which persisted after adjustment for baseline differences (for ST, adjusted hazard ratio, HR 0.32; 95% confidence interval, 95% CI 0.10-1.02, P = 0.053; for TVR, HR 0.40; 95% CI 0.22-0.75, P = 0.004). Compared to SES, EES implantation was associated with lower TVR and a trend towards lower ST. Compared to PES, EES implantation was associated with less ST and TVR and trends towards lower death/MI and MACE. In the EES group, no ST was seen after the first 3 months. CONCLUSIONS: The use of EES compared to FG-DES appears to be associated with reductions in ST and TVR at 2-year follow-up. Improved outcomes with EES are observed in comparison with SES as well as PES.
No takes yet. Share an insight, caveat, or question.
Harjai et al. (2013) conducted a cohort in percutaneous coronary intervention (n=2,126). Everolimus-eluting stents (EES) vs. First generation drug-eluting stents (FG-DES; sirolimus-eluting stent or paclitaxel-eluting stent) was evaluated on target vessel revascularization (TVR) (HR 0.40, 95% CI 0.22-0.75, p=0.004). Everolimus-eluting stents were associated with lower target vessel revascularization (adjusted HR 0.40; 95% CI 0.22-0.75; P=0.004) compared to first-generation drug-eluting stents at 2 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: