Temporal Trends in the Outcomes of Percutaneous Coronary Intervention With Zotarolimus Eluting Stents Versus Everolimus Eluting Stents: A Meta‐Analysis of Randomized Controlled Trials

Author:

Basit Jawad12,Ahmed Mushood1,Shafiq Aimen3,Zaheer Zaofashan4,Nashwan Abdulqadir J.5ORCID,Ahmed Aleena4,Hamza Mohammad6ORCID,Naseer Usman7,Ali Shafaqat8,Gupta Neelesh9,Sattar Yasar10,Kawsara Akram10,Daggubati Ramesh10,Alraies M. Chadi11ORCID

Affiliation:

1. Department of Medicine Rawalpindi Medical University Rawalpindi Pakistan

2. Cardiovascular Analytics Group Canterbury UK

3. Department of Medicine Dow University of Health Sciences Karachi Pakistan

4. Department of Medicine King Edward Medical University Lahore Pakistan

5. Hamad Medical Corporation Doha Qatar

6. Guthrie Medical Group Cortland New York USA

7. Department of Cardiology USD Sanford School of Medicine Sioux Falls South Dakota USA

8. Department of Internal Medicine Louisiana State University Shreveport Louisiana USA

9. Department of Cardiology, Kirk Kerkorian School of Medicine University of Nevada Las Vegas Las Vegas Nevada USA

10. Department of Interventional Cardiology West Virginia University Morgantown West Virginia USA

11. Department of Cardiology, Detroit Medical Center Wayne State University Detroit Michigan USA

Abstract

ABSTRACTIntroductionLong‐term follow‐up results of various trials comparing Zotarolimus eluting stents (ZES) with Everolimus eluting stents (EES) have been published recently. Additionally, over the last decade, there have been new trials comparing the ZES with various commercially available EES. We aim to conduct an updated meta‐analysis in light of new evidence from randomized controlled trials (RCTs) to provide comprehensive evidence regarding the temporal trends in the clinical outcomes.MethodsA comprehensive literature search was conducted across PubMed, Cochrane, and Embase. RCTs comparing ZES with EES for short (<2 years), intermediate (2–3 years), and long‐term follow‐ups (3–5 years) were included. Relative risk was used to pool the dichotomous outcomes using the random effects model employing the inverse variance method. All statistical analysis was conducted using Revman 5.4.ResultsA total of 18 studies reporting data at different follow‐ups for nine trials (n = 14319) were included. At short‐term follow‐up (<2 years), there were no significant differences between the two types of stents (all‐cause death, cardiac death, Major adverse cardiovascular events (MACE), target vessel myocardial infarction, definite or probable stent thrombosis or safety outcomes (target vessel revascularization, target lesion revascularization, target vessel failure, target lesion failure). At intermediate follow‐up (2–3 years), EES was superior to ZES for reducing target lesion revascularization (RR = 1.28, 95% CI = 1.05–1.58, p < 0.05). At long‐term follow‐up (3–5 years), there were no significant differences between the two groups for any of the pooled outcomes (p > 0.05).ConclusionZES and EES have similar safety and efficacy at short, intermediate, and long‐term follow‐ups.

Publisher

Wiley

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