Key result
Ultrathin BP-SES shows comparable target lesion failure risk versus thin DP-DES in ACS patients.
Why the study?
Although ultrathin bioabsorbable-polymer sirolimus-eluting stents may offer superior performance over thin durable-polymer drug-eluting stents, their long-term safety in ACS remained unknown.
Do ultrathin bioabsorbable-polymer sirolimus-eluting stents reduce target lesion failure compared to thin durable-polymer drug-eluting stents in patients with acute coronary syndrome?
Meta-Analysis (n=7,522)
Do ultrathin bioabsorbable-polymer sirolimus-eluting stents reduce target lesion failure compared to thin durable-polymer drug-eluting stents in patients with acute coronary syndrome?
Relative Risk: 0.87 (95% CI 0.73–1.04)
Absolute Event Rate: 9.5% vs 10.8%
p-value: p=.12
Ultrathin bioabsorbable-polymer sirolimus-eluting stents demonstrate comparable long-term safety and efficacy to thin durable-polymer drug-eluting stents in patients with acute coronary syndrome.
Supports flexible stent selection in ACS; reinforces comparable long-term efficacy versus durable-polymer platforms.
BACKGROUND: Because of the advancement of bioabsorbable polymers and thinner struts, bioabsorbable-polymer sirolimus-eluting stents (BP-SES) with ultrathin struts may be related to superior performance when compared to durable-polymer drug-eluting stents (DP-DES) with thin struts. Nonetheless, the long-term safety of ultrathin BP-SES in acute coronary syndrome (ACS) remains unknown. METHODS: We sought to assess the long-term safety of ultrathin BP-SES in ACS patients, conducting a thorough meta-analysis of all relevant trials drawing a comparison between ultrathin BP-SES and contemporary thin DP-DES. Target lesion failure (TLF), which includes cardiac death (CD), target-vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularization (CD-TLR) was considered the primary endpoint. Multiple databases comprising Embase, MEDLINE, Cochrane Library, and Pubmed were all thoroughly searched. RESULTS: There were seven randomized controlled trials included in our study with 7522 randomized patients with ACS (BP-SES = 3888, DP-DES = 3634). TLF occurred in 371 (9.5% in BP-SES) and 393 (10.8% in DP-DES) patients, respectively, across a 40.7-month weighted mean follow-up, with no statistically significant group differences (risk ratio [RR]: 0.87; 95% confidence interval [CI]: 0.73-1.04; p = .12). Furthermore, no significant differences in cardiac death (RR: 0.96; 95% CI: 0.68-1.35; p = .81), TV-MI (RR: 0.63; 95% CI: 0.36-1.10; p = .10) and CD-TLR (RR: 0.77; 95% CI: 0.46-1.29; p = .32) were detected between two groups. CONCLUSION: During a follow-up of 40.7 months, ultrathin BP-SES and thin DP-DES had a comparable risk of TLF and its individual components (CD, TV-MI, and CD-TLR), indicating that ultrathin BP-SES held at least the same safety and efficiency as thin DP-DES presented in patients with ACS.
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Li et al. (2023) conducted a meta-analysis in Acute coronary syndrome (n=7,522). Ultrathin bioabsorbable-polymer sirolimus-eluting stents (BP-SES) vs. Thin durable-polymer drug-eluting stents (DP-DES) was evaluated on Target lesion failure (TLF) (RR 0.87, 95% CI 0.73-1.04, p=.12). Ultrathin bioabsorbable-polymer sirolimus-eluting stents had a comparable risk of target lesion failure compared to thin durable-polymer stents in ACS patients (RR 0.87; 95% CI 0.73-1.04; p=0.12).
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