Comparative Efficacy of Sirolimus-Eluting Stents and Paclitaxel-Eluting Stents in East Asian Versus non-East Asian Patients: A Systematic Review & Meta-Analysis.

BACKGROUND: First-generation drug-eluting stents - such as the sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) - have become attractive options for percutaneous coronary intervention (PCI) and are still widely used in Asia. However, the effect of East Asian ethnicity on their efficacy remains unclear.

METHODS: Pubmed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials comparing the efficacy of the Cypher SES and Taxus PES. The outcomes of interest were stent thrombosis, target lesion revascularization (TLR), target vessel revascularization (TVR), myocardial infarction (MI), cardiac mortality, and all-cause mortality. Pooled 'East Asian' studies were compared against pooled 'non-East Asian' studies.

RESULTS: SES significantly reduced stent thrombosis incidence in East Asian patients relative to PES. Irrespective of East Asian status, SES significantly reduced the incidence of TLR and TVR as compared to PES.

CONCLUSIONS: The Cypher SES appears to be a superior choice over the Taxus PES for East Asian patients on account of its reduced risk of stent thrombosis in these patients. Irrespective of East Asian ethnic status, the Cypher SES also yields a significantly reduced incidence of TLR and TVR as compared to the Taxus PES. This article is protected by copyright. All rights reserved.