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Review
. 2018 Dec 11:38:13-21.
doi: 10.1016/j.amsu.2018.12.003. eCollection 2019 Feb.

Polymer-free versus durable polymer drug-eluting stents in patients with coronary artery disease: A meta-analysis

James J Wu  1   2 , Joshua A H Way  1 , Leonard Kritharides  1   2 , David Brieger  1   2
Affiliations
Review

Polymer-free versus durable polymer drug-eluting stents in patients with coronary artery disease: A meta-analysis

James J Wu et al. Ann Med Surg (Lond). .

Abstract

Background: Polymer-free drug-eluting stents (PF-DES) were introduced with the aim of reducing the risk of stent thrombosis associated with durable polymer drug-eluting stents (DP-DES). The comparison of safety and efficacy profiles between these two stent platforms remains unclear.

Materials and methods: We conducted electronic database searches for randomized controlled trials (RCTs) comparing patients treated with either PF-DES or DP-DES. Outcomes included definite or probable stent thrombosis (ST), myocardial infarction (MI), cardiac death, all-cause death, target lesion revascularization (TLR), and target vessel revascularization (TVR). A random-effects model was used to derive risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup analyses based on different variables were also performed. After screening a total of 1026 articles, the present meta-analysis included 13 RCTs comprising 8021 patients.

Results: No significant differences were found for the risks of definite or probable ST (RR, 0.94; 95% CI, 0.62-1.43; P = 0.77), MI (RR, 1.06; 95% CI, 0.85-1.33; P = 0.61), cardiac death (RR, 0.98; 95% CI, 0.80-1.21; P = 0.88), all-cause death (RR, 0.87; 95% CI, 0.76-1.00; P = 0.06), TLR (RR, 1.12; 95% CI, 0.94-1.33; P = 0.22), and TVR (RR, 1.18; 95% CI, 0.87-1.61; P = 0.29). Similarly, no significant differences were found for all outcomes regardless of anti-proliferative drug, except for an increased risk of TLR for polymer-free paclitaxel-eluting stents compared with DP-DES (RR, 2.32, 95% CI, 1.30-4.14; P = 0.005).

Conclusions: Our findings showed that PF-DES and DP-DES confer equivalent safety and efficacy profiles, with similar rates of stent thrombosis.

Keywords: Coronary artery disease; Drug-eluting stents; Durable polymer; Meta-analysis; Polymer-free.

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Figures

Fig. 1
Fig. 1
Study selection process.
Fig. 2
Fig. 2
Risk of definite or probable stent thrombosis. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
Fig. 3
Fig. 3
Risk of myocardial infarction. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
Fig. 4
Fig. 4
Risk of cardiac death. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
Fig. 5
Fig. 5
Risk of all-cause death. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
Fig. 6
Fig. 6
Risk of target lesion revascularization. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
Fig. 7
Fig. 7
Risk of target vessel revascularization. DP-DES = durable polymer drug-eluting stents. M-H = Mantel-Haenszel. PF-DES = polymer-free drug-eluting stents.
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References

    1. Iqbal J., Gunn J., Serruys P.W. Coronary stents: historical development, current status, and future directions. Br. Med. Bull. 2013;106:193–211. - PubMed
    1. Goto K., Zhao Z., Matsumura M., Dohi T., Kobayashi N., Kirtane A.J. Mechanisms and patterns of intravascular ultrasound in-stent restenosis among bare metal stents and first- and second-generation drug-eluting stents. Am. J. Cardiol. 2015;116(9):1351–1357. - PubMed
    1. Holmes D.R., Kereiakes D.J., Garg S., Serruys P.W., Dehmer G.J., Ellis S.G. Stent thrombosis. J. Am. Coll. Cardiol. 2010;56(17):1357–1365. - PubMed
    1. Joner M., Finn A.V., Farb A., Mont E.K., Kolodgie F.D., Ladich E. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J. Am. Coll. Cardiol. 2006;48(1):193–202. - PubMed
    1. Dores H., Raposo L., Teles R.C., Machado C., Leal S., Gonçalves P.A. Stent thrombosis with second- versus first-generation drug-eluting stents in real-world percutaneous coronary intervention: analysis of 3806 consecutive procedures from a large-volume single-center prospective registry. J. Invasive Cardiol. 2013;25(7):330–336. - PubMed