A mixed treatment comparison for short- and long-term outcomes of bare metal and drug eluting coronary stents

Background
The increasing use of drug eluting stents in interventional cardiology calls for assessment of their efficacy and safety, both among drug eluting and bare-metal stents, in the context of rational decision making.

Methods
We searched for papers that compared any of the sirolimus eluting stents, paclitaxel eluting stents, drug eluting stent, biodegradable stent, everolimus eluting stents, zotarolimus resolute eluting stent, biolimus eluting stent, bare metal Stent and zotarolimus eluting stents. The search was contacted through Medline, the Cochrane database, Embase, TCTMD, ClinicalTrials.gov, Clinical Trial Results, CardioSource, abstracts and presentations from major cardiovascular meetings. We also searched for further articles cited by selected papers. Further, important conferences and relevant proceedings and abstracts, such as the American Heart Association, American College of Cardiology, Transcatheter Cardiovascular Therapeutics, Society of Cardiovascular Angiography and Intervention, European Society of Cardiology, and Euro-PCR, were also searched. Inclusion criteria were: Randomised Controlled Trials (RCT), size of study ( ≥ 100 patients), duration more than 6 months and definition of reported endpoints (Target Vessel Revascularization, Thrombosis, Myocardial Infarction and Cardiac death). Analysis of the data was performed for short term (less than a year) and long term (more than a year). A mixed treatment comparison approach was utilized for the data analysis.

Conclusions
Based on the rankings of each treatment, a distinct difference between 2nd and 1st generation stents was identified. We can conclude that everolimus, resolute and biolimus carry the highest probabilities of being superior for all endpoints.