title: Biodegradable polymer stents vs second generation drug eluting stents: A meta-analysis and systematic review of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the premise, that biodegradable polymer drug eluting stents (BD-DES) could improve clinical outcomes compared to second generation permanent polymer drug eluting stents (PP-DES), we pooled the data from all the available randomized control trials (RCT) comparing the clinical performance of both these stents.
  
  
  METHODS
  A systematic literature search of PubMed, Cochrane, Google scholar databases, EMBASE, MEDLINE and SCOPUS was performed during time period of January 2001 to April 2015 for RCT and comparing safety and efficacy of BD-DES vs second generation PP-DES. The primary outcomes of interest were definite stent thrombosis, target lesion revascularization, myocardial infarction, cardiac deaths and total deaths during the study period.
  
  
  RESULTS
  A total of 11 RCT's with a total of 12644 patients were included in the meta-analysis, with 6598 patients in BD-DES vs 6046 patients in second generation PP-DES. The mean follow up period was 16 mo. Pooled analysis showed non-inferiority of BD-DES, comparing events of stent thrombosis (OR = 1.42, 95%CI: 0.79-2.52, P = 0.24), target lesion revascularization (OR = 0.99, 95%CI: 0.84-1.17, P = 0.92), myocardial infarction (OR = 1.06, 95%CI: 0.86-1.29, P = 0.92), cardiac deaths (OR = 1.07, 95%CI 0.82-1.41, P = 0.94) and total deaths (OR = 0.96, 95%CI: 0.80-1.17, P = 0.71).
  
  
  CONCLUSIONS
  BD-DES, when compared to second generation PP-DES, showed no significant advantage and the outcomes were comparable between both the groups.
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Bhavi
authors.initials: B
authors.lastname: Pandya
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Sainath
authors.initials: S
authors.lastname: Gaddam
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Raza
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Deepak
authors.initials: D
authors.lastname: Asti
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Nalluri
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vazzana
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: Ruben
authors.initials: R
authors.lastname: Kandov
authors.affiliation: Bhavi Pandya, Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, United States.
authors.forename: James
authors.initials: J
authors.lastname: Lafferty
keywords: Biodegradable drug eluting stent; Cobalt-chromium stent; Drug eluting stent; Stent design; Zotarolimus eluting stent