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Meta-Analysis
. 2024;20(9):485-497.
doi: 10.1080/14796678.2024.2370688. Epub 2024 Jul 9.

Polymer-free stents for percutaneous coronary intervention in diabetic patients: a systematic review and meta-analysis

Filippo Luca Gurgoglione  1 , Davide Donelli  1 , Michele Antonelli  2 , Luigi Vignali  3 , Giorgio Benatti  3 , Emilia Solinas  3 , Iacopo Tadonio  3 , Giulia Magnani  3 , Andrea Denegri  3 , Davide Lazzeroni  4 , Rocco Antonio Montone  5 , Riccardo C Bonadonna  6 , Francesco Nicolini  7 , Diego Ardissino  1 , Giampaolo Niccoli  1
Affiliations
Meta-Analysis

Polymer-free stents for percutaneous coronary intervention in diabetic patients: a systematic review and meta-analysis

Filippo Luca Gurgoglione et al. Future Cardiol. 2024.

Abstract

Aim: To compare the efficacy of polymer-free drug-eluting stents (PF-DES) versus other stents in diabetic patients with coronary artery disease undergoing percutaneous coronary interventions.Materials & methods: A systematic review and meta-analysis were performed to identify pertinent randomized controlled trials. The primary end point was the occurrence of target lesion failure.Results: Eight randomized controlled trials were included for a total of 4854 subjects. The PF-DES group experienced a trend in favor of a lower rate of target lesion failure (Incidence rate ratio = 0.91; p = 0.11) and a significantly lower rate of cardiac mortality, as compared with the control group (Incidence rate ratio = 0.82; p = 0.04). However, statistical significance was lost if bare-metal stent patients were excluded and a trend in favor of the PF-DES strategy was reported only for cardiac mortality.Conclusion: PF-DES could be a valuable strategy in diabetic patients with coronary artery disease undergoing percutaneous coronary interventions.

Keywords: atherosclerosis; diabetes mellitus; meta-analysis; percutaneous coronary intervention; polymer-free drug-eluting stents; prognosis.

Plain language summary

What is this summary about? Polymer-free drug-eluting stents (PF-DES) are a novel type of coronary stent with potential benefits in terms of chronic coronary inflammation. This is a comprehensive, up-to-date, systematic review and meta-analysis of randomized controlled trials comparing the efficacy of PF-DES versus other stents in diabetic patients with coronary artery disease undergoing percutaneous coronary intervention.What were the results? Patients treated with PF-DES experienced similar prognosis, with a trend toward better outcomes, as compared with conventional stents.What do the results mean? PF-DES could represent a novel and effective strategy for treating coronary artery disease in diabetic patients.

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Conflict of interest statement

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
PRISMA flow diagram of the systematic review and meta-analysis.
Figure 2.
Figure 2.
Incidence rate ratio of target lesion failure between polymer-free drug-eluting stents group and control group. BMS: Bare-metal stents; CI: Confidence interval; DES: Drug-eluting stent; MH: Mantel–Haenszel.
Figure 3.
Figure 3.
Incidence rate ratio of target lesion failure between polymer-free drug-eluting stents group and control group. BMS: Bare-metal stent; CI: Confidence interval; DES: Drug-eluting stent; MH: Mantel–Haenszel.
Figure 4.
Figure 4.
Incidence rate ratio of cardiac death between polymer-free drug-eluting stents group and control group. BMS: Bare-metal stent; CI: Confidence interval; DES: Drug-eluting stent; MH: Mantel–Haenszel.
Figure 5.
Figure 5.
Incidence rate ratio of cardiac death between polymer-free drug-eluting stents group and control group according to antiplatelet therapy regimen. BMS: Bare-metal stent; CI: Confidence interval; DAPT: Dual antiplatelet therapy; DES: Drug-eluting stent; MH: Mantel–Haenszel.
See this image and copyright information in PMC

References

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