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

ObjectiveWe 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.MethodsA 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.ResultsEES 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).ConclusionAmong those three types of stents, EES should be the first recommended stent for DM patients.