title: Long-term outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer everolimus-eluting stents: A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Both biodegradable polymer biolimus-eluting stents (BP-BES) and biocompatible durable polymer everolimus-eluting stents (DP-EES) have been developed to decrease the risk of late adverse events. However, their efficacy and safety beyond 1year after stent deployment still remain controversial.
  
  
  METHODS
  We conducted a meta-analysis on randomized controlled trials (RCTs) comparing BP-BES with DP-EES in patients undergoing percutaneous coronary intervention in long-term follow up (beyond 1year), and compared the pooled estimates with those in mid-term follow up (within 1year).
  
  
  RESULTS
  Eight RCTs were included in this meta-analysis. The risks in BP-BES versus DP-EES of death (odds ratio (OR): 1.06, 95% confidence interval (CI): 0.86-1.31, p=0.557 for long-term; OR: 1.09, 95% CI: 0.76-1.56, p=0.645 for mid-term), myocardial infarction (OR: 1.06, 95% CI: 0.84-1.35, p=0.628 for long-term; OR: 1.04, 95% CI: 0.81-1.33, p=0.778 for mid-term), and definite or probable stent thrombosis (OR: 0.89, 95% CI: 0.51-1.57, p=0.695 for long-term; OR: 1.36, 95% CI: 0.66-2.81, p=0.400 for mid-term) were comparable in each follow up, respectively. In contrast, the risk of target vessel revascularization (TVR) tended to be higher in BP-BES as compared to DP-EES in long-term follow up (OR: 1.15, 95% CI: 0.97-1.37, p=0.098 for long-term; OR: 1.09, 95% CI: 0.87-1.36, p=0.447 for mid-term).
  
  
  CONCLUSIONS
  Although the overall clinical outcomes were similar between BP-BES and DP-EES, BP-BES may be associated with higher risk of TVR up to 3years after stent deployment compared with DP-EES. Further studies are warranted in larger populations of patients during longer-term follow up.
authors.affiliation: Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan. Electronic address: yoshimune-tky@umin.ac.jp.
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakurai
authors.affiliation: Cardiac Rehabilitation Department, Institute for Rehabilitation, Belgrade, Serbia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Burazor
authors.affiliation: Highlands Consulting, Inc., San Jose, CA, United States.
authors.forename: Heidi N
authors.initials: HN
authors.lastname: Bonneau
authors.affiliation: Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneda
mesh_terms: D020341:Absorbable Implants; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D006801:Humans; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods
keywords: Biodegradable polymer biolimus-eluting stent; Durable polymer everolimus-eluting stent; Meta-analysis; Randomized controlled trial