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- Title
Polymer-free versus permanent polymer-coated drug eluting stents for the treatment of coronary artery disease: A meta-analysis of randomized trials.
- Authors
Nogic, Jason; Baey, Yi‐Wei; Nerlekar, Nitesh; Ha, Francis J.; Cameron, James D.; Nasis, Arthur; West, Nick E. J.; Brown, Adam J.; Baey, Yi-Wei
- Abstract
<bold>Background: </bold>Polymer-free drug eluting stents (PF-DES) were developed, in part, to overcome risk of late ischemic events observed with permanent polymer-coated DES (PP-DES). However, trial results are inconsistent with longer-term safety and efficacy of PF-DES remaining unknown. We performed a meta-analysis of randomized trials assessing outcomes of patients receiving PF-DES versus PP-DES for treatment of coronary artery disease (CAD).<bold>Methods: </bold>Electronic searches were performed for randomized trials comparing outcomes between PF-DES and PP-DES. Trials reporting major adverse cardiovascular events (MACE), myocardial infarction (MI), stent thrombosis (ST), all-cause death, target lesion/vessel revascularization (TLR/TVR), and late lumen loss (LLL) were included. Analyses were performed at longest follow-up and landmarked beyond 1-year.<bold>Results: </bold>Twelve trials (6,943 patients) were included. There was no significant difference in MACE between PF-DES and PP-DES at longest follow-up (Odds Ratio [OR] 0.96, 95%CI 0.85-1.10, P = 0.59) or landmark analysis beyond 1-year (OR 0.96, 95%CI 0.76-1.20, P = 0.70). Although PF-DES were associated with a significant reduction in all-cause death (OR 0.85, 95%CI 0.72-1.00, P < 0.05), this effect was not present on landmark analysis beyond 1-year (OR 0.89, 95%CI 0.73-1.10, P = 0.30). There were no differences observed for MI (OR 1.00, 95%CI 0.77-1.28, P = 0.99) or ST (OR 0.95, 95%CI 0.54-1.68, P = 0.86), with similar efficacy outcomes including TVR (OR 1.07, 95%CI 0.91-1.26, P = 0.42), TLR (OR 1.03, 95%CI 0.88-1.21, P = 0.68) and angiographic LLL (pooled mean difference 0.01 mm, 95%CI -0.08 to 0.11, P = 0.76).<bold>Conclusions: </bold>PF-DES are as safe and efficacious as PP-DES for the treatment of patients with CAD, but do not significantly reduce late ischemic complications.
- Subjects
SURGICAL stents; CLINICAL trials; META-analysis; THROMBOSIS; CORONARY disease; CORONARY heart disease surgery; MEDICAL equipment; BIOMEDICAL materials; CARDIOVASCULAR system; HEALTH outcome assessment; POLYMERS; SYSTEMATIC reviews; TREATMENT effectiveness; DRUG-eluting stents
- Publication
Journal of Interventional Cardiology, 2018, Vol 31, Issue 5, p608
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12522