A meta-analysis of everolimus-eluting stents versus sirolimus-eluting stents and paclitaxel-eluting stents in diabetic patients

• Published in: Journal of cardiothoracic surgery Vol. 16; no. 1; p. 90
• Main Authors: Ouyang, Hang, Zeng, Xuehui, Zhang, Chunlei, Song, Linli, Xu, Jiarui, Hou, Zhihui, Xie, Siya, Tao, Zheng, He, Jincai
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.04.2021; BioMed Central; BMC
• Subjects: Blood clot; Care and treatment; Clinical trials; Diabetes; Diabetes mellitus; Diabetics; Everolimus-eluting stent; Health aspects; Heart attack; Heart attacks; Implants; Lesions; Meta-analysis; Mortality; Myocardial infarction; Paclitaxel; Paclitaxel-eluting stents; Rapamycin; Sensitivity analysis; Sirolimus-eluting stents; Stent (Surgery); Stents; Thromboembolism; Thrombosis; Diabetes; Paclitaxel-eluting stents; Everolimus-eluting stent; Sirolimus-eluting stents; Meta-analysis
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-021-01452-8

We performed this meta-analysis to determine which stent among everolimus eluting stents (EES), sirolimus eluting stents (SES) and paclitaxel eluting stents (PES) should be preferred for the treatment of DM patients. A systematic search of publications about randomized controlled trials (RCTs) focused on diabetic patients received EES, SES or PES was conducted. We evaluated the following indicators: target vessel revascularization (TVR), target lesion revascularization (TLR), late luminal loss (LLL), stent thrombosis (ST), myocardial infarction (MI), all-cause mortality and cardiac mortality. EES showed obvious advantages over SES for DM patients, as it induced the lowest rate of target vessel revascularization and target lesion revascularization (TLR) (p = 0.04). In addition, EES induced lower in-segment LLL than PSE and SES and lower in-stent LLL than PES in DM patients (all p < 0.05). Moreover, EES effectively reduced all-cause mortality compared to SES (RR = 0.71, 95% CI: 0.52-0.99, p = 0.04) and MI rates compared to PES (RR = 0.44, 95% CI: 0.26-0.73, p = 0.0002). Furthermore, EES could reduce the ST rate compared with both SES (RR = 0.53, 95% CI: 0.28-0.98, p = 0.04) and PES (RR = 0.18, 95% CI: 0.07-0.51, p = 0.001). Among those three types of stents, EES should be the first recommended stent for DM patients.