title: Stent thrombosis with biodegradable polymer drug-eluting stents versus durable polymer sirolimus-eluting stents: an update meta-analysis.
abstract: OBJECTIVE
  Durable polymer sirolimus-eluting stents (DP-SES) are associated with a low risk of stent thrombosis; biodegradable polymer drug-eluting stents (BP-DES) were designed to reduce these risks. However, their benefits are still variable.
  
  
  METHODS
  We undertook a meta-analysis of randomized trials identified by systematic searches of Medline, Embase, and the Cochrane Database.
  
  
  RESULTS
  Eleven studies (9,676 patients) with a mean follow-up of 22.6 months were included. Overall, compared with DP-SES, BP-DES significantly lowered the rate of definite or probable stent thrombosis (RR, 0.73; 95% CI, 0.55-0.97; p = 0.03; I(2) = 0.0%) due to a decreased risk of very late stent thrombosis (RR, 0.26; 95% CI, 0.11-0.63; p = 0.00; I(2) = 0.0%). However, BP-DES were associated with a comparable rate of early and late stent thrombosis. Meanwhile, BP-DES were associated with a broadly equivalent risk of target vessel revascularization (RR, 0.90; 95% CI, 0.78-1.03; p = 0.13; I(2) = 0.0%), cardiac death (RR, 0.89; 95% CI, 0.72-1.09; p = 0.24; I(2) = 0.0%), myocardial infarction (RR, 1.03; 95% CI, 0.84-1.26; p = 0.79; I(2) = 0.0%), and major adverse cardiac events (MACE; RR, 0.91; 95% CI, 0.83-1.0; p = 0.08; I(2) = 0.0%). Furthermore, angiographic data showed that in-stent and in-segment late luminal loss were similar between the two groups.
  
  
  CONCLUSIONS
  Compared with DP-SES, BP-DES were associated with a lower rate of very late stent thrombosis and an equivalent risk of MACE. Larger randomized studies are needed to confirm this finding.
authors.affiliation: Department of Cardiology and Neurology, Beijing Second Hospital, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.forename: Yi Ning
authors.initials: YN
authors.lastname: Lv
authors.forename: Li Yu
authors.initials: LY
authors.lastname: Wang
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D011108:Polymers; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use*; D013927:Thrombosis / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D011108:Polymers; D020123:Sirolimus