Another Meta-Analysis of Bare-Metal and Drug-Eluting Stents

A study of outcomes helps to clarify the balance of the risks and benefits of the three most commonly used stent types.

In a network meta-analysis carefully designed to integrate direct and indirect evidence, investigators pooled data from 38 randomized trials comparing the efficacy and safety of paclitaxel-eluting stents (PES), sirolimus-eluting stents (SES), and bare-metal stents (BMS) in various combinations. The analysis encompassed 18,023 patients with up to 4 years of follow-up.

Overall mortality and rates of cardiac death were similar with all three devices. MI was less frequent with SES than with either PES (hazard ratio, 0.83) or BMS (HR, 0.81). In 27 trials reporting definite stent thrombosis, there were no between-device differences in stent thrombosis rates up to 30 days after implantation. However, the rate of late stent thrombosis (up to 4 years…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI