Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 28;13(24):2868-2878.
doi: 10.1016/j.jcin.2020.09.014.

Target Lesion Failure With Current Drug-Eluting Stents: Evidence From a Comprehensive Network Meta-Analysis

Nevio Taglieri  1 , Antonio G Bruno  2 , Gabriele Ghetti  2 , Cinzia Marrozzini  2 , Francesco Saia  2 , Nazzareno Galié  2 , Tullio Palmerini  2
Affiliations
Free article

Target Lesion Failure With Current Drug-Eluting Stents: Evidence From a Comprehensive Network Meta-Analysis

Nevio Taglieri et al. JACC Cardiovasc Interv. .
Free article

Abstract

Objectives: The aim of this study was to investigate the efficacy and safety of currently used drug-eluting stents (DES).

Background: Head-to-head comparisons among newer DES have shown conflicting results.

Methods: For this network meta-analysis, randomized controlled trials comparing different types of currently used DES were searched in PubMed, Scopus, and proceedings of international meetings. The primary endpoint was target lesion failure (TLF) at 1 year and at long-term follow-up.

Results: Seventy-seven trials with 99,039 patients were selected for this network meta-analysis. Among the 10 DES included in the meta-analysis, 4 received the most extensive investigation: Orsiro, XIENCE, Nobori/BioMatrix, and Resolute. At 1 year, the Orsiro stent was associated with lower rates of TLF compared with XIENCE (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.71 to 0.98; p = 0.03), Resolute (OR: 0.81; 95% CI: 0.68 to 0.95; p = 0.01), and Nobori/BioMatrix (OR: 0.81; 95% CI: 0.67 to 0.98; p = 0.03). Orsiro had the highest probability to be the best (70.8%), with a surface under the cumulative ranking curve value of 95.9%. However, after a median follow-up period of 50 months (range: 24 to 60 months), no significant difference was apparent in the rates of TLF between any DES, although Orsiro still ranked as the best stent (58.6% probability to be the best). In addition, Orsiro had a lower rate of long-term definite stent thrombosis compared with Nobori/BioMatrix (OR: 0.60; 95% CI: 0.36 to 0.98; p = 0.04) and lower rates of definite and probable stent thrombosis compared with Resolute (OR: 0.66; 95% CI: 0.45 to 0.99; p = 0.04). No differences in cardiac mortality between any DES were observed.

Conclusions: Orsiro is associated with a lower 1-year rate of TLF compared with XIENCE, Resolute, and Nobori/BioMatrix but with an attenuation of the efficacy signal at long-term follow-up.

Keywords: bioabsorbable polymer; drug-eluting stent(s); thin strut.

PubMed Disclaimer

Conflict of interest statement

Author Disclosures This work was supported by the Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, and by the Fanti Melloni Foundation. Dr. Saia has received personal fees from Abbott Vascular, Eli Lilly, AstraZeneca, Boston Scientific, Medtronic, The Medicines Company, Biotronik, and St. Jude Medical, outside the submitted work. Dr. Palmerini has received speaker fees from Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Comment in

  • Stent Technology Reaches Maturity?
    Dangas GD, Claessen BE. Dangas GD, et al. JACC Cardiovasc Interv. 2020 Dec 28;13(24):2879-2881. doi: 10.1016/j.jcin.2020.10.004. JACC Cardiovasc Interv. 2020. PMID: 33357525 No abstract available.

Publication types

LinkOut - more resources