Related trials
BASKET-PROVE (SES), 2010 - sirolimus eluting stent vs bare-metal stent
SORT-OUT-3, 2010 - zotarolimus eluting stent vs sirolimus eluting stent
RESOLUTE All comers, 2010 - zotarolimus eluting stent vs everolimus eluting stent
SPIRIT IV, 2010 - everolimus eluting stent vs paclitaxel eluting stent
BASKET-PROVE (EES), 2010 - everolimus eluting stent vs bare-metal stent
GISSOC II, 2010 - sirolimus eluting stent vs bare-metal stent
ISAR TEST 3 (BP), 2009 - sirolimus biodegradable polymer vs sirolimus eluting stent
STICH (ventricular reconstruction), 2009 - CABG+surgical ventricular reconstruction vs CABG
ZEST (vs SES), 2009 - zotarolimus eluting stent vs sirolimus eluting stent
GENIUS-STEMI, 2009 - Genous stent vs bare-metal stent
COMPARE, 2009 - everolimus eluting stent vs paclitaxel eluting stent
DEBATER (SES vs BMS), 2009 - sirolimus eluting stent vs bare-metal stent
SYNTAX, 2009 - paclitaxel eluting stent vs CABG
BARI 2D, 2009 - CABG or PCI vs medical treatment
ISAR TEST 3 (PF), 2009 - polymer free sirolimus stent vs sirolimus eluting stent
ISAR-TEST-4 (biodegradable polymer), 2009 - sirolimus biodegradable polymer vs sirolimus eluting stent
ISAR TEST 2 (vs ZES), 2009 - dual sirolimus, probucol eluting stent vs zotarolimus eluting stent
PASEO, 2009 - drug-eluting stents vs bare-metal stent
ISAR-LEFT-MAIN, 2009 - sirolimus eluting stent vs paclitaxel eluting stent
Thiele, 2009 - sirolimus ES vs MIDCAB
ENDEAVOR IV, 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
ZEST AMI (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
ISAR TEST 2 (vs SES), 2009 - dual sirolimus, probucol eluting stent vs sirolimus eluting stent
ZEST (vs PES), 2009 - zotarolimus eluting stent vs paclitaxel eluting stent
Costar II, 2008 - CoStar stent vs paclitaxel eluting stent
See also:
All coronary artery disease clinical trials
All stable angina clinical trials
All clinical trials of myocardial revascularization
All clinical trials of everolimus eluting stent
|
|
Treatments
Studied treatment |
polymer based,
everolimus-eluting stent (Xience V)
|
Control treatment |
polymer-based,
paclitaxel-eluting stent (Taxus Liberte)
|
Treatments description |
multivessel treatment |
26.5% |
|
Patients
Patients |
unselected patients |
Inclusion criteria |
patients aged 18�85 years; referred for elective or emergent percutaneous coronary intervention; no limitations about the number of lesions or vessels, location of lesions, or their length; life expectancy >5 years |
Exclusion criteria |
no dual antiplatelet therapy for 1 year; cardiogenic shock; planned major surgery within 1 month |
Baseline characteristics |
age |
63.2 y |
history of MI (%) |
16.5% |
diabetes (%) |
18% |
Smoker (%) |
31% |
unstable angina (%) |
23% |
LAD (%) |
38.5% |
RCA (%) |
33% |
LCx (%) |
24.5% |
lesion length (mm) |
16.4 mm |
reference-vessel diameter |
2.55 mm |
Female (%) |
30% |
lesions in a bypass graft |
2% |
left main coronary artery disease |
2% |
totally occluded lesions |
3.5% |
bifurcated lesions |
17.5% |
ostial lesion |
19% |
STEMI |
25% |
Stable angina |
38% |
No of lesions per patients |
1.46 |
|
Method and design
Randomized effectives |
897 / 903 (studied vs. control) |
Design |
Parallel groups |
Blinding |
open |
Follow-up duration |
1 y (2y) |
Number of centre |
single centre |
Geographic area |
the Netherlands |
Primary endpoint |
death, MI,TVR |
Results
Endpoints and data reported in the trial's publication(s)
Endpoint |
Events (%) |
Relative Risk |
95% CI |
|
Studied treat. |
Control treat. |
All-cause mortality |
18 / 897 (2,0%) |
15 / 903 (1,7%) |
1,21 |
[0,61;2,38] |
|
Cardiac death |
11 / 897 (1,2%) |
10 / 903 (1,1%) |
1,11 |
[0,47;2,59] |
|
Myocardial infarction |
25 / 897 (2,8%) |
48 / 903 (5,3%) |
0,52 |
[0,33;0,84] |
|
Q wave MI |
3 / 897 (0,3%) |
11 / 903 (1,2%) |
0,27 |
[0,08;0,98] |
|
Non-Q wave MI |
22 / 897 (2,5%) |
39 / 903 (4,3%) |
0,57 |
[0,34;0,95] |
|
All-cause mortality or myocardial infarction |
42 / 897 (4,7%) |
62 / 903 (6,9%) |
0,68 |
[0,47;1,00] |
|
Cardiac death or myocardial infarction |
35 / 897 (3,9%) |
57 / 903 (6,3%) |
0,62 |
[0,41;0,93] |
|
Target vessel revascularisation (clinically justified) |
19 / 897 (2,1%) |
51 / 903 (5,6%) |
0,38 |
[0,22;0,63] |
|
Percutaneous TVR(clinically justified) |
13 / 897 (1,4%) |
38 / 903 (4,2%) |
0,34 |
[0,18;0,64] |
|
Surgical TVR(clinically justified) |
6 / 897 (0,7%) |
13 / 903 (1,4%) |
0,46 |
[0,18;1,22] |
|
Target vessel revascularisation (any) |
21 / 897 (2,3%) |
54 / 903 (6,0%) |
0,39 |
[0,24;0,64] |
|
Percutaneous TVR (any) |
15 / 897 (1,7%) |
41 / 903 (4,5%) |
0,37 |
[0,21;0,66] |
|
Surgical TVR (any) |
6 / 897 (0,7%) |
13 / 903 (1,4%) |
0,46 |
[0,18;1,22] |
|
Target lesion revascularisation (clinically justified) |
15 / 897 (1,7%) |
43 / 903 (4,8%) |
0,35 |
[0,20;0,63] |
|
Percutaneous TLR(clinically justified) |
9 / 897 (1,0%) |
31 / 903 (3,4%) |
0,29 |
[0,14;0,61] |
|
Surgical TLR(clinically justified) |
6 / 897 (0,7%) |
12 / 903 (1,3%) |
0,50 |
[0,19;1,34] |
|
Target lesion revascularisation (any) |
18 / 897 (2,0%) |
48 / 903 (5,3%) |
0,38 |
[0,22;0,64] |
|
Percutaneous TLR (any) |
12 / 897 (1,3%) |
36 / 903 (4,0%) |
0,34 |
[0,18;0,64] |
|
Surgical TLR (any) |
6 / 897 (0,7%) |
12 / 903 (1,3%) |
0,50 |
[0,19;1,34] |
|
death, MI, TVR |
56 / 897 (6,2%) |
82 / 903 (9,1%) |
0,69 |
[0,50;0,95] |
|
Secondary endpoint |
44 / 897 (4,9%) |
74 / 903 (8,2%) |
0,60 |
[0,42;0,86] |
|
Stent thrombosis (definite and probable) |
6 / 897 (0,7%) |
23 / 903 (2,5%) |
0,26 |
[0,11;0,64] |
|
Late stent thrombosis (30 days to 1 year after procedure) |
4 / 897 (0,4%) |
8 / 903 (0,9%) |
0,50 |
[0,15;1,67] |
|
Definite stent thrombosis |
4 / 897 (0,4%) |
18 / 903 (2,0%) |
0,22 |
[0,08;0,66] |
|
Endpoints used by the meta-analysis and data retained for this trial
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
MACE
35 / 897
57 / 903
0,62 [0,41;0,93]
All cause death
18 / 897
15 / 903
classic
1,21 [0,61;2,38]
cardiac death
11 / 897
10 / 903
classic
1,11 [0,47;2,59]
MI (fatal and non fatal)
25 / 897
48 / 903
0,52 [0,33;0,84]
target-vessel revascularization
19 / 897
51 / 903
0,38 [0,22;0,63]
target lesion revascularisation
15 / 897
43 / 903
0,35 [0,20;0,63]
Acute stent thrombosis (<=24h)
1 / 897
1 / 903
classic
1,01 [0,06;16,07]
sub acute stent thrombosis (1-30 days)
1 / 897
14 / 903
0,07 [0,01;0,55]
4y stent thrombosis (ARC)
4 / 897
18 / 903
0,22 [0,08;0,66]
Stent thrombosis (any, end of follow up)
6 / 897
23 / 903
0,26 [0,11;0,64]
2 yr MACE
81 / 897
124 / 903
0,66 [0,50;0,86]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
MACE
|
35 / 897 (3,9%) |
57 / 903 (6,3%) |
0,62 |
[0,41;0,93] |
Cardiac death or myocardial infarction |
|
All cause death
|
18 / 897 (2,0%) |
15 / 903 (1,7%) |
1,21 |
[0,61;2,38] |
All-cause mortality |
|
cardiac death
|
11 / 897 (1,2%) |
10 / 903 (1,1%) |
1,11 |
[0,47;2,59] |
Cardiac death |
|
MI (fatal and non fatal)
|
25 / 897 (2,8%) |
48 / 903 (5,3%) |
0,52 |
[0,33;0,84] |
Myocardial infarction |
|
target-vessel revascularization
|
19 / 897 (2,1%) |
51 / 903 (5,6%) |
0,38 |
[0,22;0,63] |
Target vessel revascularisation (clinically justified) |
|
target lesion revascularisation
|
15 / 897 (1,7%) |
43 / 903 (4,8%) |
0,35 |
[0,20;0,63] |
Target lesion revascularisation (clinically justified) |
|
Acute stent thrombosis (<=24h)
|
1 / 897 (0,1%) |
1 / 903 (0,1%) |
1,01 |
[0,06;16,07] |
Acute stent thrombosis (on date of procedure) |
|
sub acute stent thrombosis (1-30 days)
|
1 / 897 (0,1%) |
14 / 903 (1,6%) |
0,07 |
[0,01;0,55] |
Subacute stent thrombosis (1�30 days after procedure) |
|
4y stent thrombosis (ARC)
|
4 / 897 (0,4%) |
18 / 903 (2,0%) |
0,22 |
[0,08;0,66] |
Definite stent thrombosis |
|
Stent thrombosis (any, end of follow up)
|
6 / 897 (0,7%) |
23 / 903 (2,5%) |
0,26 |
[0,11;0,64] |
Stent thrombosis (definite and probable) 1y |
|
2 yr MACE
|
81 / 897 (9,0%) |
124 / 903 (13,7%) |
0,66 |
[0,50;0,86] |
all death, nonfatal MI, and TVR |
|
The primary endpoint (if exists) appears in blod characters
|
Reference(s) used for data extraction:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction
|
Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
MACE |
3,90% |
6,31% |
-24,1‰
|
All cause death |
2,01% |
1,66% |
3,5‰
|
cardiac death |
1,23% |
1,11% |
1,2‰
|
MI (fatal and non fatal) |
2,79% |
5,32% |
-25,3‰
|
target-vessel revascularization |
2,12% |
5,65% |
-35,3‰
|
target lesion revascularisation |
1,67% |
4,76% |
-30,9‰
|
Acute stent thrombosis (<=24h) |
1,11‰ |
1,11‰ |
0,0‰
|
sub acute stent thrombosis (1-30 days) |
1,11‰ |
1,55% |
-14,4‰
|
4y stent thrombosis (ARC) |
4,46‰ |
1,99% |
-15,5‰
|
Stent thrombosis (any, end of follow up) |
6,69‰ |
2,55% |
-18,8‰
|
2 yr MACE |
9,03% |
13,73% |
-47,0‰
|
Meta-analysis of all similar trials:
Drug eluting stent in coronary artery disease for all type of patients
Drug eluting stent in coronary artery disease for unparticular patients
myocardial revascularization in stable angina for all type of patient
Reference(s)
-
Kedhi E, Joesoef KS, McFadden E, Wassing J, van Mieghem C, Goedhart D, Smits PC.
Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice (COMPARE): a randomised trial..
Lancet 2010 Jan 16;375:201-9
- 10.1016/S0140-6736(09)62127-9
Pubmed
|
Hubmed
| Fulltext
|