Related trials
		 
			
				 
				
					SORT-OUT-3, 2010 - zotarolimus eluting stent  vs sirolimus eluting stent
				
			 
			
				 
				
					SPIRIT IV, 2010 - everolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					RESOLUTE All comers, 2010 - zotarolimus eluting stent  vs everolimus eluting stent
				
			 
			
				 
				
					BASKET-PROVE (EES), 2010 - everolimus eluting stent  vs bare-metal stent
				
			 
			
				 
				
					ISAR-DESIRE-2, 2010 - sirolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					GISSOC II, 2010 - sirolimus eluting stent  vs bare-metal stent
				
			 
			
				 
				
					BASKET-PROVE (SES), 2010 - sirolimus eluting stent  vs bare-metal stent
				
			 
			
				 
				
					STICH (ventricular reconstruction), 2009 - CABG+surgical ventricular reconstruction  vs CABG
				
			 
			
				 
				
					ISAR TEST 2 (vs ZES), 2009 - dual sirolimus, probucol eluting stent  vs zotarolimus eluting stent
				
			 
			
				 
				
					SYNTAX, 2009 - paclitaxel eluting stent  vs CABG
				
			 
			
				 
				
					SYNTAX (unprotected left main sub group), 2009 - DES  vs CABG
				
			 
			
				 
				
					ISAR-LEFT-MAIN, 2009 - sirolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					COMPARE, 2009 - everolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					ISAR TEST 3 (PF), 2009 - polymer free sirolimus stent  vs sirolimus eluting stent
				
			 
			
				 
				
					PASEO, 2009 - drug-eluting stents  vs bare-metal stent
				
			 
			
				 
				
					ZEST AMI (vs PES), 2009 - zotarolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					ISAR TEST 2 (vs SES), 2009 - dual sirolimus, probucol eluting stent  vs sirolimus eluting stent
				
			 
			
				 
				
					BARI 2D, 2009 - CABG or PCI  vs medical treatment
				
			 
			
				 
				
					ISAR-TEST-4 (biodegradable polymer), 2009 - sirolimus biodegradable polymer  vs sirolimus eluting stent
				
			 
			
				 
				
					ISAR TEST 3 (BP), 2009 - sirolimus biodegradable polymer  vs sirolimus eluting stent
				
			 
			
				 
				
					GENIUS-STEMI, 2009 - Genous stent  vs bare-metal stent
				
			 
			
				 
				
					ENDEAVOR IV, 2009 - zotarolimus eluting stent  vs paclitaxel eluting stent
				
			 
			
				 
				
					ZEST (vs SES), 2009 - zotarolimus eluting stent  vs sirolimus eluting stent
				
			 
			
				 
				
					ZEST AMI (vs SES), 2009 - zotarolimus eluting stent  vs sirolimus eluting stent
				
			 
			
				 
				
					Thiele, 2009 - sirolimus ES  vs MIDCAB
				
			 
		 
		 
		 
		
		See also:
		 
			
				
					All coronary artery disease clinical trials
				
			
			
				
					All stable angina clinical trials
				
			
		
			
			All clinical trials of myocardial revascularization 
			
		
		
			
			All clinical trials of sirolimus eluting stent 
			
		
	 | 
	
		 
	 | 
	
	Treatments
	
	
		| Studied treatment | 
		
		Paclitaxel-eluting stent
		 
		
		
		 | 
	 
	
		| Control treatment | 
		
		Sirolimus-eluting stent
		 
		
		
		 | 
	 
		
			| Concomittant treatment | 
			clopidogrel 600 mg at least 2 hours before the procedure in addition to 500 mg of intravenous aspirin; clopidogrel (150 mg/day until discharge, 75 mg/day thereafter) and aspirin 200 mg/day indefinitely. | 
		 
	 
	
	
	
	Patients
	
		
			| Patients | 
			Unprotected Left Main Coronary Artery Disease | 
		 
		
			| Exclusion criteria | 
			Age 4.5 mm by visual estimation; Malignancies with life expectancy 
		 |  
				| Baseline characteristics | 
					
					
						
							| age | 
							69y  | 
						 
						
							| unstable angina  (%) | 
							42%  | 
						 
						
							| reference-vessel diameter | 
							3.8mm  | 
						 
						
							| Female (%) | 
							23%  | 
						 
						
							| ostial lesion | 
							11%  | 
						 
						
							| multi vessels patients | 
							75%  | 
						 
					 						
					 | 
				 
	 
	
	
	
	
	
	
	Method and design
	
	
		| Randomized effectives | 
		302 / 305 (studied vs. control) | 
	 
		
			| Design | 
			Parallel groups | 
		 
		
			| Blinding | 
			open | 
		 
		
			| Follow-up duration | 
			1 year | 
		 
		
			| Hypothesis | 
			Non inferiority | 
		 
		
			| Primary endpoint | 
			death, MI, TLR | 
		 
	
	 
	
	
	
	
	
	
	
  
	Results	
	
	
	
		
	
	
		
			Endpoint
		
	
	
		
		Studied treat. n/N
			
	
	
		
		Control treat. n/N
		
	
	
		
			Graph
		
	
	
		
			RR [95% CI]
		
	
	
		
			
				
				MACE
				 
			
		
			
				
				NA / 302 
				
			
			
				
				NA / 305 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,85 [0,55;1,32]
				
			
	
	
		
			
				
				All cause death
				 
			
		
			
				
				15 / 302 
				
			
			
				
				20 / 305 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,76 [0,40;1,45]
				
			
	
	
		
			
				
				MI (fatal and non fatal)
				 
			
		
			
				
				15 / 302 
				
			
			
				
				14 / 305 
				
			
		
			
				
					
						classic
					
					
					
				
			
				
				
			
			
		
			
				
					1,08 [0,53;2,20]
				
			
	
	
		
			
				
				angiographic restenosis 
				 
			
		
			
				
				48 / 302 
				
			
			
				
				59 / 305 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,82 [0,58;1,16]
				
			
	
	
		
		
		
		
		
			
				0
			
		
		
		
		
		
				2
		
		
		
		
		
			1.0
		
	
  
 
	 
		
	
		
		
				
					| 
						Relative risks
					 | 
				 
			
			| Endpoint | 
			Events (%) | 
			Relative Risk | 
			95% CI | 
			Endpoint definition in the trial | 
			Ref | 
			 
			
			| Studied treat. | 
			Control treat. | 
			 
					
					
						| 
							All cause death
						 | 
						15 / 302 (5,0%) | 
						20 / 305 (6,6%) | 
						0,76 | 
						[0,40;1,45] | 
						 | 
						 | 
					 
					
					
						| 
							MI (fatal and non fatal)
						 | 
						15 / 302 (5,0%) | 
						14 / 305 (4,6%) | 
						1,08 | 
						[0,53;2,20] | 
						 | 
						 | 
					 
					
					
					
					
					
						| 
							angiographic restenosis 
						 | 
						48 / 302 (15,9%) | 
						59 / 305 (19,3%) | 
						0,82 | 
						[0,58;1,16] | 
						 | 
						 | 
					 
					
					
					
					
					
					
					
					
					
					
					
					
					
		
			| 
			The primary endpoint (if exists) appears in blod characters
			 | 
		 
		
			| 
			Reference(s) used for data extraction: 
				
					0: 
				
			 | 
		 
		 
		
		
			
			| Endpoint | 
			studied treat. | 
			control treat. | 
			mean diff | 
			 
		 
	 
	
	
	
				
					| 
						Absolute risk reduction 
					 | 
				 
	
		| Endpoint | 
		Events rate | 
		Absolute risk reduction (ARR) | 
	 
	
		| Studied treat. | 
		Control treat. | 
	 
			
				| All cause death | 
				4,97% | 
				6,56% | 
				
					-15,9‰
				 | 
			 
			
				| MI (fatal and non fatal) | 
				4,97% | 
				4,59% | 
				
					3,8‰
				 | 
			 
			
				| angiographic restenosis  | 
				15,89% | 
				19,34% | 
				
					-34,5‰
				 | 
			 
	 	
	 
Meta-analysis of all similar trials: 
			
				
					Drug eluting stent in coronary artery disease for all type of patients
				
			 
			
				
					Drug eluting stent in coronary artery disease for unprotected left main artery stenosis
				
			 
			
				
					myocardial revascularization in coronary artery disease for all type of patient
				
			 
			
				
					myocardial revascularization in stable angina for all type of patient
				
			 
	
  
	
	
	
	
	
	
	
	
	
	
	
		 
		Reference(s)
	
	
	
			- 
				
			    Mehilli J, Kastrati A, Byrne RA, Bruskina O, Iijima R, Schulz S, Pache J, Seyfarth M, Massberg S, Laugwitz KL, Dirschinger J, Schömig A. 
			    Paclitaxel- versus sirolimus-eluting stents for unprotected left main coronary artery disease..
			    J Am Coll Cardiol 2009 May 12;53:1760-8
			    
 
				
					 
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