Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents for patients with coronary artery disease: an update meta-analysis.
OBJECTIVE
Permanent polymer drug-eluting stents (DES) are associated with a higher risk of late and very late stent thrombosis (ST); biodegradable polymer drug-eluting stents (BP-DES) were designed to reduce these risks. However, their benefits are not completely clear.


METHODS
We undertook a meta-analysis of randomized studies identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Eligible studies were those that compared BP-DES with second-generation permanent polymer DES in patients undergoing percutaneous coronary intervention.


RESULTS
Five studies (8,740 patients) with a mean follow-up of 19.2 months were included. Overall, BP-DES were associated with a broadly equivalent risk of definite and probable ST (odds ratio [OR], 1.07; 95 % confidence interval [CI], 0.67 to 1.71; P = 0.76; I (2) = 5.0 %), target vessel revascularization (OR, 1.04; 95 % CI, 0.87 to 1.24; P = 0.68; I (2) = 38.0 %), all-cause mortality (OR, 1.10; 95 % CI, 0.87 to 1.41; P = 0.42; I (2) = 0.0 %), and major adverse cardiac events (OR, 1.03; 95 % CI, 0.88 to 1.20; P = 0.74; I (2) = 0.0 %) when compared with second-generation DES. However, BP-DES significantly decreased in-stent late luminal loss (standard mean difference [SMD], -0.01; 95 % CI, -0.12 to 0.11; P = 0.93; I (2) = 0.0 %) and in-segment late luminal loss (SMD, -0.06; 95 % CI, -0.17 to 0.05; P = 0.27; I (2) = 0.0 %) compared with second-generation DES.


CONCLUSIONS
Compared with second-generation permanent polymer DES, biodegradable stents appear to have equivalent short- to medium-term clinical benefits, and it remains unclear whether they reduce the incidence of very late ST.
Department of Cardiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Henan, 0086-470052, China.
Yanyu
Y
Wang
Pingshuan
P
Dong
Ling
L
Li
Xiaoling
X
Li
Hongyun
H
Wang
Xuming
X
Yang
Shaoxin
S
Wang
Zhuanzhen
Z
Li
Xiyan
X
Shang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D019344:Lactic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D011091:Polyesters; D011100:Polyglycolic Acid / Q000627:therapeutic use*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
D020099:Coated Materials, Biocompatible; D011091:Polyesters; D011108:Polymers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; C033616:poly(lactide)