{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T04:35:13Z","timestamp":1767933313540,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T00:00:00Z","timestamp":1516838400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>The efficacy of second\u2010generation drug\u2010eluting stents (DES; eg, everolimus and zotarolimus) compared with bare\u2010metal stents (BMS) in patients undergoing percutaneous coronary intervention was challenged recently by new evidence from large clinical trials. Thus, we aimed to conduct an updated systematic review and meta\u2010analysis of randomized clinical trials (RCTs) evaluating the efficacy and safety of second\u2010generation DES compared with BMS<jats:bold>.<\/jats:bold> Electronic databases were systematically searched for all RCTs comparing second\u2010generation DES with BMS and reporting clinical outcomes. The primary efficacy outcome was major adverse cardiac events (MACE); the primary safety outcome was definite stent thrombosis. The DerSimonian and Laird method was used for estimation of summary risk ratios (RR). A total of 9 trials involving 17 682 patients were included in the final analysis. Compared with BMS, second\u2010generation DES were associated with decreased incidence of MACE (RR: 0.78, 95% confidence interval [CI]: 0.69\u20100.88), driven by the decreased incidence of myocardial infarction (MI) (RR: 0.67, 95% CI: 0.48\u20100.95), target\u2010lesion revascularization (RR: 0.47, 95% CI: 0.42\u20100.53), definite stent thrombosis (RR: 0.57, 95% CI: 0.41\u20100.78), and definite\/probable stent thrombosis (RR: 0.54, 95% CI: 0.38\u20100.80). The incidence of all\u2010cause mortality was similar between groups (RR: 0.94, 95% CI: 0.79\u20101.10). Meta\u2010regression showed lower incidences of MI with DES implantation in elderly and diabetic patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.026 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001, respectively). Compared with BMS, second\u2010generation DES appear to be associated with a lower incidence of MACE, mainly driven by lower rates of target\u2010lesion revascularization, MI, and stent thrombosis. However, all\u2010cause mortality appears similar between groups.<\/jats:p>","DOI":"10.1002\/clc.22855","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T12:42:51Z","timestamp":1516884171000},"page":"151-158","source":"Crossref","is-referenced-by-count":15,"title":["Safety and efficacy of second\u2010generation drug\u2010eluting stents compared with bare\u2010metal stents: An updated meta\u2010analysis and regression of 9 randomized clinical trials"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2459-5195","authenticated-orcid":false,"given":"Ahmed N.","family":"Mahmoud","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine University of Florida  Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2717-1427","authenticated-orcid":false,"given":"Nikhil 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Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amgad","family":"Mentias","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Iowa  Iowa City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-4616","authenticated-orcid":false,"given":"Amr F.","family":"Barakat","sequence":"additional","affiliation":[{"name":"UPMC Heart and Vascular Institute University of Pittsburgh  Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruv","family":"Mahtta","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Florida  Gainesville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"David Anderson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine University of Florida  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