Abstract
Biodegradable polymer biolimus-eluting stents (BP-BES) are third-generation drug-eluting stents (DES) composed of biodegradable polymers that may improve prognosis after percutaneous coronary intervention (PCI). After five years of follow-up, BP-BES showed conflicting results compared to durable polymer drug-eluting stents (DP-DES). We performed a meta-analysis of the outcomes of studies on BP-BES and DP-DES after percutaneous coronary intervention (PCI) at five years of follow-up. Eligible studies were retrieved from PubMed, Embase and the Cochrane Library and reported the results of all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and stent thrombosis (ST) at five years of follow-up. Five studies of a total of 4687 patients were included in the meta-analysis. At five years of follow-up, BP-BES was associated with lower rates of major adverse cardiac events (MACE) (OR = 0.83, 95%CI = [0.71, 0.97]), TLR (OR = 0.77, 95%CI = [0.62, 0.96]) and ST (OR = 0.60, 95%CI = [0.43 to 0.84]), whereas no significant differences in mortality, MI, or TVR rates were detected. Our results demonstrated that at five years of follow-up, BP-BES can significantly reduce the risk of MACE, TLR and ST, which indicate that safety and efficacy were increased after PCI.
Highlights
Application of drug-eluting stents (DES) has had a great impact on percutaneous coronary intervention (PCI)
biodegradable polymer biolimus-eluting stents (BP-Biolimus-eluting stents (BES)) significantly reduced the risk of major adverse cardiac events (MACE) compared to durable polymer drug-eluting stents (DP-DES) (18.8% versus 19.0%; odds risk (OR) [95% CI] = 0.83 [0.71, 0.97], P = 0.02; I2 = 0%, Pheterogeneity = 0.56)
The most inspiring finding of our meta-analysis was that BP-BES can significantly reduce the risk of MACE, target lesion revascularization (TLR) and stent thrombosis (ST) without benefits on death, myocardial infarction (MI), or target vessel revascularization (TVR)
Summary
Application of drug-eluting stents (DES) has had a great impact on percutaneous coronary intervention (PCI). Compared with bare metal stents (BMS), a reduced risk of restenosis and target lesion revascularization were observed with DES in previous clinical trials[1,2,3,4]. Because of their efficacy in limiting neointimal hyperplasia, DES were treated as a standard therapy in PCI. Self-perpetuating inflammation and late stent thrombosis (ST) were associated with the durable polymer used in the first- and second-generation DES5–11. To overcome these adverse events, biodegradable polymer drug eluting stents (BP-DES) were developed. The aim of this study was to perform a meta-analysis of the outcomes associated with BP-BES and DP-DES for the treatment of PCI at five years of follow-up
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