AI Article Synopsis
- Biodegradable-polymer (BP) and polymer-free (PF) drug-eluting stents (DES) were created to minimize delayed arterial healing compared to durable-polymer stents (DP).
- A meta-analysis reviewed five studies with nearly 2000 patients, examining the effectiveness and safety of BP-DES versus PF-DES.
- Results indicated BP-DES had significantly lower rates of target vessel and lesion revascularization, as well as reduced late lumen loss, with no notable differences in safety outcomes like death or myocardial infarction.
Article Abstract
Background/purpose: Biodegradable-polymer (BP) and polymer-free (PF) drug eluting stents (DES) were developed to reduce the risk of delayed arterial healing observed with durable-polymer (DP) platforms. Although trials demonstrate BP-DES and PF-DES are non-inferior to DP-DES, there is limited data directly comparing these technologies. We performed a meta-analysis to assess the efficacy and safety of BP-DES versus PF-DES for the treatment of coronary artery disease.
Methods/materials: Electronic searches were performed identifying randomized trials comparing BP-DES with PF-DES. Co-primary efficacy endpoints were target vessel revascularization (TVR), target lesion revascularization (TLR) and angiographic in-stent late lumen loss (LLL). Co-secondary safety endpoints were all-cause death, myocardial infarction (MI) and stent thrombosis (ST).
Results: Of 208 studies, 5 met inclusion criteria including 1975 patients. At mean follow-up (14 ± 5 months), BP-DES were associated with significantly reduced rates of TVR (OR 0.58, 95%CI 0.37-0.92, p = 0.02), TLR (4.7% vs 9.5%) (OR 0.48, 95%CI 0.31-0.75, p = 0.001) and in-stent LLL (pooled mean difference -0.20 mm, 95%CI -0.24 to -0.16, p < 0.001). There was no difference in safety, including all-cause death (OR 1.24, 95%CI 0.68-2.28, p = 0.48), MI (OR 0.92, 95%CI 0.54-1.56, p = 0.75) or ST (OR 1.58, 95%CI 0.67-3.73, p = 0.30).
Conclusions: These data suggests that BP-DES are more efficacious when compared with PF-DES for the treatment of CAD.
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| http://dx.doi.org/10.1016/j.carrev.2018.12.010 | DOI Listing |
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