Efficacy and safety of biodegradable polymer sirolimus-eluting stents versus durable polymer drug-eluting stents: A meta-analysis of randomized trials

Abstract

BackgroundA meta-analysis was performed to investigate the safety and efficacy of biodegradable polymer sirolimus-eluting stents (BP-SESs) compared with durable polymer drug-eluting stents (DP-DESs). MethodsOnline databases, including PubMed, EMBASE and the Cochrane Library, were searched for randomized controlled trials that compared BP-SESs and DP-DESs and reported rates of overall and cardiac mortality, myocardial infarction (MI), stent thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR) and late lumen loss (LLL). ResultsA total of 15 studies investigating 14,187 patients were included in the meta-analysis. The BP-SESs significantly reduced the risk of late ST (OR: 0.57; 95% CI: 0.33–0.98; p=0.04), very late ST (OR: 0.53; 95% CI: 0.29–0.97; p=0.04) and in-stent LLL (MD: −0.06, 95% CI: −0.11 to −0.01; p=0.01) compared with the DP-DESs but did not improve mortality (OR: 0.95; 95% CI: 0.81–1.11; p=0.52), cardiac mortality (OR: 0.89; 95% CI: 0.72–1.10; p=0.27), MI (OR: 0.90; 95% CI: 0.76–1.08; p=0.27), TLR (OR: 0.95; 95% CI: 0.81–1.11; p=0.51), TVR (OR: 0.96; 95% CI: 0.81–1.13; p=0.62) or in-segment LLL (MD: −0.03, 95% CI: −0.06–0.01; p=0.10). ConclusionsIn this meta-analysis of randomized controlled trials, the BP-SESs were superior to the DP-DESs in terms of late ST, very late ST and in-stent LLL. Further large randomized controlled trials with long-term follow-up are required to validate the benefits of BP-SESs.