Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events

Patient level meta-analysis

Marco Valgimigli, Manel Sabaté, Christoph Kaiser, Salvatore Brugaletta, Jose Maria De La Torre Hernandez, Soeren Galatius, Angel Cequier, Franz Eberli, Adam De Belder, Patrick W. Serruys, Giuseppe Ferrante

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Objectives: To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents.

Design: Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported.

Data sources and study selection: Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients.

Primary outcomes: The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death.

Results: The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; P

Conclusions This meta-analysis offers evidence that compared with bare metal stents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis.

Original languageEnglish
Article number3362
JournalBritish Medical Journal
Volume349
DOIs
Publication statusPublished - Nov 5 2014

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Chromium
Cobalt
Stents
Meta-Analysis
Metals
Thrombosis
Randomized Controlled Trials
Myocardial Infarction
Everolimus
Confidence Intervals
Mortality
Information Storage and Retrieval
Cause of Death

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events : Patient level meta-analysis. / Valgimigli, Marco; Sabaté, Manel; Kaiser, Christoph; Brugaletta, Salvatore; De La Torre Hernandez, Jose Maria; Galatius, Soeren; Cequier, Angel; Eberli, Franz; De Belder, Adam; Serruys, Patrick W.; Ferrante, Giuseppe.

In: British Medical Journal, Vol. 349, 3362, 05.11.2014.

Research output: Contribution to journalArticle

Valgimigli, M, Sabaté, M, Kaiser, C, Brugaletta, S, De La Torre Hernandez, JM, Galatius, S, Cequier, A, Eberli, F, De Belder, A, Serruys, PW & Ferrante, G 2014, 'Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: Patient level meta-analysis', British Medical Journal, vol. 349, 3362. https://doi.org/10.1136/bmj.g6427
Valgimigli, Marco ; Sabaté, Manel ; Kaiser, Christoph ; Brugaletta, Salvatore ; De La Torre Hernandez, Jose Maria ; Galatius, Soeren ; Cequier, Angel ; Eberli, Franz ; De Belder, Adam ; Serruys, Patrick W. ; Ferrante, Giuseppe. / Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events : Patient level meta-analysis. In: British Medical Journal. 2014 ; Vol. 349.
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AU - Kaiser, Christoph

AU - Brugaletta, Salvatore

AU - De La Torre Hernandez, Jose Maria

AU - Galatius, Soeren

AU - Cequier, Angel

AU - Eberli, Franz

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