Key result
Biodegradable polymer drug-eluting stents showed no significant difference in major adverse cardiac events compared to permanent polymer stents at one year (OR 1.05), but tended to lower long-term risk.
Why the study?
Do biodegradable polymer drug-eluting stents reduce major adverse cardiac events and stent thrombosis compared to permanent polymer drug-eluting stents in patients with coronary stenosis?
Meta-Analysis (n=15,938)
Yes
Do biodegradable polymer drug-eluting stents reduce major adverse cardiac events and stent thrombosis compared to permanent polymer drug-eluting stents in patients with coronary stenosis?
Odds Ratio: 1.05 (95% CI 0.93–1.18)
p-value: p=0.45
Biodegradable polymer drug-eluting stents are noninferior to permanent polymer stents at one year and may offer a better safety profile regarding stent thrombosis at long-term follow-up.
Biodegradable polymer stents are noninferior at one year with possible long-term advantage; extends meta-analytic support for polymer choice in coronary disease.
Several types of biodegradable polymer drug-eluting stents (BPDES) have been used for percutaneous transluminal angioplasty; however, the safety and efficiency of these BPDES have not been fully evaluated. A meta-analysis was, therefore, conducted to compare the clinical performance of BPDES with that of permanent polymer drug-eluting stents (PPDES) in unselected patients with coronary stenosis. PubMed, Web of Science, Medline and The Cochrane Library were searched for randomized clinical trials (RCTs) from January 2005 to January 2014. Trials that compared BPDES with PPDES in patients with coronary stenosis were considered. Twelve RCTs with a total of 15,938 patients with coronary stenosis were included in this meta-analysis. No significant difference was found between the two arms in the incidence of major adverse cardiac events (MACE) and definite or probable stent thrombosis (DpST) at the one-year follow-up (P>0.10). The use of BPDES, however, showed a tendency towards a lower risk of MACE (P=0.09) and a beneficial effect by reducing DpST episodes (P=0.04) at long-term follow-up, particularly when compared with the incidence of DpST at the one-year follow-up. BPDES also tended to be associated with a decreased late lumen loss in patients with coronary stenosis [instrumental variable =-0.04; 95% confidence interval =-0.08-0.00; P=0.05). In conclusion, the one-year outcomes following drug-eluting stent implantation showed BPDES were noninferior to PPDES in unselected patients with coronary stenosis. Long-term clinical outcomes, however, indicated that BPDES appeared to a present a lower risk of MACE and DpST.
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Wang et al. (2015) conducted a meta-analysis in Coronary stenosis (n=15,938). Biodegradable polymer drug-eluting stents vs. Permanent polymer drug-eluting stents was evaluated on Major adverse cardiac events (MACE) at one-year follow-up (OR 1.05, 95% CI 0.93-1.18, p=0.45). Biodegradable polymer drug-eluting stents showed no significant difference in major adverse cardiac events compared to permanent polymer stents at one year (OR 1.05), but tended to lower long-term risk.
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