Comparative efficacy of polymer-free versus biodegradable-polymer drug-eluting stents in percutaneous coronary intervention: an updated systematic review and meta-analysis.
Sebastian Jaramillo, Juan Pinilla, Francesco Stabile, Vinicius Bittar de Pontes, Mohammad Cheikh Ibrahim, Webster Donaldy, Wilton Gomes
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引用次数: 0
Abstract
Background: Biodegradable polymer drug-eluting stents (BP-DES) are currently used in percutaneous coronary intervention (PCI). Polymer-free drug-eluting stents (PF-DES) have the potential to mitigate any risk associated with BP-DES; however, the relative efficacy and safety of these interventions remain to be fully elucidated.
Methods: A systematic search of PubMed, Embase, and Cochrane Central was performed from inception to January 2025 to identify randomized controlled trials and observational studies comparing PF-DES with BP-DES in patients undergoing PCI. Heterogeneity was assessed using the I ² statistic. A two-sided P value less than 0.05 was considered statistically significant. Prespecified subgroup analyses were conducted based on follow-up duration.
Results: A total of seven randomized controlled trials (RCTs) and four observational studies comprising 11 954 patients were included, of whom 5947 (49.7%) received PF-DES. In the pooled analysis, no statistically significant differences were observed between PF-DES and BP-DES in terms of cardiac death [risk ratio: 1.12, 95% confidence interval (CI): 0.96-1.31, P = 0.15], target lesion failure (risk ratio: 1.09, 95% CI: 0.81-1.46, P = 0.58), stent thrombosis (risk ratio: 0.90, 95% CI: 0.58-1.41, P = 0.64), target lesion revascularization (risk ratio: 1.28, 95% CI: 0.81-2.02, P = 0.28), or target vessel revascularization (risk ratio: 1.05, 95% CI: 0.70-1.58, P = 0.79). Likewise, no significant subgroup effect was observed regarding longer-term follow-up outcomes.
Conclusion: This meta-analysis found comparable safety and efficacy outcomes between PF-DES and BP-DES in patients undergoing PCI; however, further RCTs are needed to evaluate long-term outcomes and newer-generation stent models.
期刊介绍：
Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management.
Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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