Five-year clinical efficacy and safety of contemporary thin-strut biodegradable polymer versus durable polymer drug-eluting stents: a systematic review and meta-analysis of 9 randomized controlled trials
- 17 August 2019
- journal article
- review article
- Published by Springer Science and Business Media LLC in Cardiovascular Intervention and Therapeutics
- Vol. 35 (3), 250-258
- https://doi.org/10.1007/s12928-019-00613-w
Abstract
Very long-term data of the biodegradable polymer drug-eluting stents (BP-DES) in comparison with the contemporary durable polymer DES (DP-DES) are still to be investigated. We aimed to investigate the very long-term clinical performance of contemporary BP-DES against the DP-DES. We performed a systematic review to evaluate very long-term clinical outcomes of BP-DES versus DP-DES. Inclusion criteria were randomized design comparing BP-DES against DP-DES and follow-up duration >= 36 months. MEDLINE, EMBASE, and CENTRAL without restricting language or publication status were searched up to December 2018. The primary efficacy and safety endpoints were target lesion failure (TLF; a composite of cardiac death, target vessel myocardial infarction and ischemia-driven target lesion revascularization) and definite/probable stent thrombosis (ST), respectively. Primary analysis was done for the contemporary thin-strut BP- and DP-DES (strut thickness < 100 mu m). A total of 9 trials comprising 10,699 patients (BP-DES,n = 6241 versus DP-DES,n = 4458) were analyzed. The mean follow-up duration was 63 months. No significant difference was found in TLF [Odds ratio (95% CI) 1.04 (0.89-1.21)] and definite/probable ST (odds ratio (95% CI) 0.78 (0.59-1.01)] between the BP- and DP-DESs. The present meta-analysis suggested that the contemporary thin-strut BP- and DP-DES have similar efficacy and safety profile at 5-year follow-up. Clinical trial registrationPROSPERO; CRD42018101983.Keywords
This publication has 37 references indexed in Scilit:
- A comparison of the main outcomes from BP-BES and DP-DES at five years of follow-up: A systematic review and meta-analysisScientific Reports, 2017
- Meta-Analysis of Randomized Clinical Trials Comparing Biodegradable Polymer Drug-Eluting Stent to Second-Generation Durable Polymer Drug-Eluting StentsJACC: Cardiovascular Interventions, 2017
- The SYNERGY biodegradable polymer everolimus eluting coronary stent: Porcine vascular compatibility and polymer safety studyCatheterization and Cardiovascular Interventions, 2015
- Hypersensitivity Reaction in the US Food and Drug Administration-Approved Second-Generation Drug-Eluting Stents: Histopathological Assessment With Ex Vivo Optical Coherence TomographyCirculation, 2015
- Clinical Outcomes With Bioabsorbable Polymer- Versus Durable Polymer-Based Drug-Eluting and Bare-Metal StentsJournal of the American College of Cardiology, 2014
- Pathology of Second-Generation Everolimus-Eluting Stents Versus First-Generation Sirolimus- and Paclitaxel-Eluting Stents in HumansCirculation, 2014
- Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysisBMJ, 2013
- Contemporary Incidence and Predictors of Stent Thrombosis and Other Major Adverse Cardiac Events in the Year After XIENCE V ImplantationJACC: Cardiovascular Interventions, 2012
- Very Late Coronary Stent Thrombosis of a Newer-Generation Everolimus-Eluting Stent Compared With Early-Generation Drug-Eluting StentsCirculation, 2012
- Localized Hypersensitivity and Late Coronary Thrombosis Secondary to a Sirolimus-Eluting StentCirculation, 2004