Long-term (2\u20135 years) adverse clinical outcomes associated with ZES versus SES, PES and EES: A Meta-Analysis

Pravesh Kumar Bundhun,Abhishek Rishikesh Teeluck,Manish Pursun,Wei-Qiang Huang,Mohammad Zafooruddin Sani Soogund,Akash Bhurtu

doi:10.1038/s41598-017-06705-y

Pravesh Kumar Bundhun, Abhishek Rishikesh Teeluck + Show 4 more

Open Access

https://doi.org/10.1038/s41598-017-06705-y

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Abstract

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.

Highlights

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
Randomized Controlled Trials (RCTs) were considered relevant for this analysis if they compared Zotarolimus Eluting Stents (ZES) with SES, PES or EES, and if they reported Stent Thrombosis (ST) and/or other adverse outcomes as their endpoints during a follow up period of 2 or more years (≥2 years)
The full-text articles were again carefully reviewed, whereby a further 26 articles were eliminated since: three articles were meta-analyses and letters of correspondence respectively, 7 articles were observational studies, 8 research articles were associated with the same trial whereas 5 articles had a follow up period of less than 2 years

Summary

Introduction

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. 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. Coronary stents are special devices that are placed within narrow coronary arteries to keep them open so that the heart is supplied with a sufficient amount of blood This practice may reduce symptoms and prevent heart attacks. The drug blocks cell proliferation within coronary arteries and inhibits neointimal growth thereby preventing restenosis[2,3,4,5]

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