{"id":27391,"date":"2012-03-22T21:38:25","date_gmt":"2012-03-23T01:38:25","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=27391"},"modified":"2012-03-22T21:38:25","modified_gmt":"2012-03-23T01:38:25","slug":"large-meta-analysis-finds-very-low-thrombosis-rates-for-xience-stent","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/03\/22\/large-meta-analysis-finds-very-low-thrombosis-rates-for-xience-stent\/","title":{"rendered":"Large Meta-Analysis Finds Very Low Thrombosis Rates for Xience Stent"},"content":{"rendered":"<p><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(12)60324-9\/abstract\">A large new meta-analysis published in the\u00a0<em>Lancet<\/em><\/a>\u00a0provides the best evidence yet that the\u00a0cobalt-chromium everolimus eluting (CoCr-EES) stents (Xience and Promus)\u00a0have a significantly lower rate of stent thrombosis than bare-metal stents (BMS) and other drug-eluting stents (DES).<\/p>\n<p>Tullio Palmerini and colleagues analyzed data from 49 randomized trials comparing different stents in more than 50,000 patients.<\/p>\n<p>Odds ratios for\u00a01-year definite stent thrombosis for\u00a0CoCr-EES compared with:<\/p>\n<ul>\n<li>BMS: OR 0\u00b723, CI 0\u00b713\u20130\u00b741<\/li>\n<li>paclitaxel-eluting stents:\u00a0OR 0\u00b728, CI 0\u00b716\u20130\u00b748<\/li>\n<li>permanent polymer-based sirolimus-eluting stents: OR 0\u00b741, CI 0\u00b724\u20130\u00b770<\/li>\n<li>phosphorylcholine-based zotarolimu-seluting stents: OR 0\u00b721, CI 0\u00b710\u20130\u00b744<\/li>\n<li>Resolute zotarolimus-eluting stents: OR 0\u00b714, CI 0\u00b703\u20130\u00b747<\/li>\n<\/ul>\n<div>\n<p>The superiority of the CoCr-EES over BMS emerged within the first month, suggesting that the findings were not simply a reflection of longer duration of dual antiplatelet therapy.\u00a0At 2 years, the\u00a0CoCr-EESs still had a lower rate of definite stent thrombosis than both bare-metal stents\u00a0(OR 0\u00b735, CI 0\u00b717\u20130\u00b769) and paclitaxel-eluting stents (OR 0\u00b734, CI 0\u00b719\u20130\u00b762). Since concerns were first raised a number of years ago about the higher rate of stent thrombosis with drug-eluting stents, the new results, write the authors, represent &#8220;a paradigm shift.&#8221;<\/p>\n<p>In an accompanying comment,\u00a0John Ormiston and Mark Webster point out that a meta-analysis should only &#8220;be regarded as hypothesis-generating,&#8221; but write that &#8220;despite these limitations&#8221; the findings are &#8220;very reassuring.&#8221; They conclude: &#8220;CoCr-EES should be regarded as the standard against which future design improvements are compared.&#8221;<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>A large new meta-analysis published in the\u00a0Lancet\u00a0provides the best evidence yet that the\u00a0cobalt-chromium everolimus eluting (CoCr-EES) stents (Xience and Promus)\u00a0have a significantly lower rate of stent thrombosis than bare-metal stents (BMS) and other drug-eluting stents (DES). Tullio Palmerini and colleagues analyzed data from 49 randomized trials comparing different stents in more than 50,000 patients. Odds [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[821,1183,332,437,856],"class_list":["post-27391","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-drug-eluting-stents","tag-promus","tag-stent-thrombosis","tag-stents","tag-xience"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=27391"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27391\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=27391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=27391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=27391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}