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)

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Summary

Introduction

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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