Abstract 4613: Evaluation of the Safety of Drug Eluting Stents Between First and Second Generation: Meta-analysis of 17 Randomized Trials and 11,000 Patients
Despite the clearly demonstrated effectiveness of drug-eluting coronary stents (DES) Cypher and Taxus, new types of DES (second-generation DES) have been developed to optimize the results of percutaneous coronary interventions. The aim of this study was to compare the rate of thrombosis between first- and second-generation DES.
Methods: A meta-analysis from 17 randomized trials comparing first and second-generation DES, including more than 11,000 patients, was performed. The rate of stent thrombosis <1 year between both types of DES was compared. The following types of DES were evaluated: everolimus-DES (SPIRIT II, SPIRIT III) zotarolimus-DES (ENDEAVOR III, ENDEAVOR IV, ZEST-AMI, ZOMAXX I ZOMAXX II ISAR-TEST 2), biolimus-DES (LEADERS, NOBORI I, NOBORI-Core), DES with combination of drugs (ISAR-TEST 2), and DES releasing sirolimus or paclitaxel other than Taxus or Cypher (COSTAR II, ISAR-TEST 3).
Results: There was no heterogeneity among the studies (I2=6%, p=0.39). The rate of stent thrombosis was similar between first and second-generation DES(0.87% vs. 0.90%, respectively; p=0.59).
Conclusion: The rate of stent thrombosis within the first year after stent implantation is similar between first- and second-generation DES. To ascertain whether second-generation DES are safer than first-generation DES, longer follow-up are needed.