title: Impact of drug-eluting stents with different coating strategies on stent thrombosis: A meta-analysis of 19 randomized trials.
abstract: BACKGROUND
  Whether drug-eluting stents with biodegradable polymers (BP-DES) improve safety, especially with respect to stent thrombosis (ST) compared with permanent polymers DES (PP-DES), remains uncertain. We aimed to compare the short- and long-term outcomes and the ST risk in patients treated with BP-DES vs.
  We searched Medline, Embase, Web of science, CENTRAL databases, and conferenceproceedings/abstracts for randomized controlled trials (RCTs) comparing BP-DES with PP-DES. The primary endpoint was to compare the risks of overall and different temporalc ategories of definite/probable ST. Other clinical outcomes were target lesion revascularization (TLR), myocardial infarction (MI), and all-cause death in short-term (≤ 1 year) and long-term follow-up. The meta-analyses were performed by computing odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
  
  
  RESULTS
  Nineteen RCTs including 20,229 patients were analyzed. Overall, BP-DES significantly decreased the risks of very late definite/probable ST (OR 0.33; 95% CI 0.16-0.70), and TLR in long-term follow-up (OR 0.70; 95% CI 0.52-0.95) compared with PP-DES. There were no significant differences between the groups regarding MI incidence and mortality during both short and long follow-up periods. In stratiﬁed analyses, the long-term superiority of BP-DES was maintained only by using first-generation DES as the comparators.
  
  
  CONCLUSIONS
  The present meta-analysis indicated that BP-DES were more efficacious than PP-DES at reducing the risks of very late ST and long-term TLR, but it could vary by heterogeneities in the use of PP-DES comparators. Additional rigorous RCTs with longer follow-up periods are warranted to verify these very promising long-term endpoints.
authors: Xiaowei
authors: X
authors: Niu
authors: Cuiling
authors: C
authors: Yang
authors: De
authors: D
authors: Chen
authors: Shengliang
authors: S
authors: He
authors: Dong
authors: D
authors: Yan
authors: Department of Cardiology, The First Affiliated Hospital, L anzhou University, Lanzhou, Gansu, China. yaoyalifs@163.com.
authors: Yali
authors: Y
authors: Yao
mesh_terms: D020099:Coated Materials, Biocompatible / Q000592:standards*; D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D009203:Myocardial Infarction / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*
chemical_list: D020099:Coated Materials, Biocompatible