title: Safety and efficacy of degradable vs. permanent polymer drug-eluting stents: a meta-analysis of 18,395 patients from randomized trials.
abstract: BACKGROUND
  Degradable polymer drug-eluting stents (DP-DES) represent a promising strategy to improve the delayed healing and hypersensitive reaction in the vessel. However, the efficacy and safety of DP-DES vs. permanent polymer drug-eluting stents (PP-DES) are less well defined. The aim of this meta-analysis was to compare the total, short (<30 days), mid (30 days-1 year) and long (>1 year) term outcomes of DP-DES vs.
  PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized clinical trials to compare any of approved DP- and PP-DES. Efficacy endpoints were target-lesion revascularization (TLR) and in-stent late loss (ISLL). Safety endpoints were death, myocardial infarction (MI), and composite of definite and probable stent thrombosis (ST).
  
  
  RESULTS
  The meta-analysis included 19 RCTs (n=18,395) with interesting results. As compared with DES, there was a significantly reduced very late ST (OR [95% CI]=0.42 [0.24-0.77], p=0.852) and ISLL (OR [95% CI]=-0.07 [-0.12-0.02], p=0.000) in DP-DES patients. However, there were no differences between DP-DES and PP-DES for other safety and efficiency outcomes, except that the stratified analysis showed a significant decreased TLR with DP-DES as compared to paclitaxel-eluting stent (OR [95% CI]=0.41 [0.20-0.81], p=0.457).
  
  
  CONCLUSIONS
  DP-DES are more effective in reducing very late ST and ISLL, as well as comparable to PP-DES with regard to death, TLR and MI. Further large RCTs with long-term follow-up are warranted to better define the relative merits of DP-DES.
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
authors.forename: Shijian
authors.initials: S
authors.lastname: Liu
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Yuanlin
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Fangjuan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Huanyun
authors.initials: H
authors.lastname: Liu
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Lufeng
authors.initials: L
authors.lastname: Li
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China. Electronic address: doctorzhaoxiaohui@yahoo.com.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Cardiovascular Disease Research Center, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Huang
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects* / Q000592:standards; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000592:standards; D006801:Humans; D011108:Polymers / Q000008:administration & dosage / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D011108:Polymers
keywords: Biodegradable polymer; Drug-eluting stents (DES); Outcomes; Percutaneous coronary intervention (PCI)