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Biodegradable Polymer Drug-Eluting Stents Versus Second-Generation Drug-Eluting Stents for Patients With Coronary Artery Disease: An Update Meta-Analysis

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Abstract

Objective

Permanent polymer drug-eluting stents (DES) are associated with a higher risk of late and very late stent thrombosis (ST); biodegradable polymer drug-eluting stents (BP-DES) were designed to reduce these risks. However, their benefits are not completely clear.

Method

We undertook a meta-analysis of randomized studies identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Eligible studies were those that compared BP-DES with second-generation permanent polymer DES in patients undergoing percutaneous coronary intervention.

Results

Five studies (8,740 patients) with a mean follow-up of 19.2 months were included. Overall, BP-DES were associated with a broadly equivalent risk of definite and probable ST (odds ratio [OR], 1.07; 95 % confidence interval [CI], 0.67 to 1.71; P = 0.76; I 2 = 5.0 %), target vessel revascularization (OR, 1.04; 95 % CI, 0.87 to 1.24; P = 0.68; I 2 = 38.0 %), all-cause mortality (OR, 1.10; 95 % CI, 0.87 to 1.41; P = 0.42; I 2 = 0.0 %), and major adverse cardiac events (OR, 1.03; 95 % CI, 0.88 to 1.20; P = 0.74; I 2 = 0.0 %) when compared with second-generation DES. However, BP-DES significantly decreased in-stent late luminal loss (standard mean difference [SMD], −0.01; 95 % CI, −0.12 to 0.11; P = 0.93; I 2 = 0.0 %) and in-segment late luminal loss (SMD, −0.06; 95 % CI, −0.17 to 0.05; P = 0.27; I 2 = 0.0 %) compared with second-generation DES.

Conclusions

Compared with second-generation permanent polymer DES, biodegradable stents appear to have equivalent short- to medium-term clinical benefits, and it remains unclear whether they reduce the incidence of very late ST.

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Authors and Affiliations

  1. Department of Cardiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Henan, 0086-470052, China

    Yanyu Wang & Ling Li

  2. First Affiliated Hospital of Henan University of Science and Technology, Henan, China

    Yanyu Wang

  3. Department of Cardiology, First Affiliated Hospital of Henan University of Science and Technology, Henan, China

    Pingshuan Dong, Xiaoling Li, Hongyun Wang, Xuming Yang, Shaoxin Wang, Zhuanzhen Li & Xiyan Shang

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  1. Yanyu Wang
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  4. Xiaoling Li
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Correspondence to Ling Li.

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Wang, Y., Dong, P., Li, L. et al. Biodegradable Polymer Drug-Eluting Stents Versus Second-Generation Drug-Eluting Stents for Patients With Coronary Artery Disease: An Update Meta-Analysis. Cardiovasc Drugs Ther 28, 379–385 (2014). https://doi.org/10.1007/s10557-014-6528-7

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  • DOI: https://doi.org/10.1007/s10557-014-6528-7

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