Direct and indirect comparison meta-analysis demonstrates the superiority of sirolimus- versus paclitaxel-eluting stents across 5854 patients

Giuseppe G L Biondi-Zoccai, Marzia Lotrionte, Antonio Abbate, Marco Valgimigli, Luca Testa, Francesco Burzotta, Filippo Crea, Pierfrancesco Agostoni

Research output: Contribution to journalArticle


There is ongoing debate to identify the most effective, safe and cost-beneficial drug-eluting stent, between the two currently approved and used devices, i.e. sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES). To date, head-to-head comparison studies of SES vs PES have been however limited by relatively small sample sizes and the low number of events typically associated with these highly effective coronary devices. To overcome the drawbacks of single trials, direct and indirect comparison meta-analyses have been designed and conducted to thoroughly compare sirolimus- vs paclitaxel eluting-stents. This article provides results of a pooled analysis of such indirect and direct comparisons, definitively demonstrating across 5854 patients the superiority of SES in comparison to PES (odds ratio 0.62 [95% confidence interval 0.50-0.75], p <0.0001 for binary angiographic restenosis, and odds ratio 0.66 [0.52-0.84], p = 0.0008 for target lesion revascularization). Indeed, such combination of direct and indirect comparisons should also be envisaged to soundly and timely appraise the next generation of drug-eluting stents.

Original languageEnglish
Pages (from-to)104-105
Number of pages2
JournalInternational Journal of Cardiology
Issue number1
Publication statusPublished - Jan 2 2007



  • Drug-eluting stent
  • Meta-analysis
  • Percutaneous coronary intervention
  • Systematic review

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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