Short and long-term safety and efficacy of polymer-free vs. durable polymer drug-eluting stents. A comprehensive meta-analysis of randomized trials including 6178 patients. [Review]

MedStar author(s):
Citation: Atherosclerosis. 233(1):224-31, 2014 Mar.PMID: 24529148Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Meta-Analysis | Research Support, Non-U.S. Gov't | ReviewSubject headings: *Drug-Eluting Stents/ae [Adverse Effects] | *Randomized Controlled Trials as Topic | Humans | Myocardial Infarction/mo [Mortality] | Polymers/ae [Adverse Effects] | Probucol/ad [Administration & Dosage] | Sirolimus/ad [Administration & Dosage] | Stents/ae [Adverse Effects] | Thrombosis/pc [Prevention & Control] | Treatment OutcomeYear: 2014ISSN:
  • 0021-9150
Name of journal: AtherosclerosisAbstract: BACKGROUND: The efficacy and safety of polymer-free drug-eluting stents (DESs) in clinical practice is currently subject of debate; randomized trials (RCTs) conducted so far provided conflicting results or were underpowered to definitively address this question; we aimed to investigate the efficacy and safety profile of polymer-free vs. durable polymer DES by a comprehensive meta-analysis of RCTs.CONCLUSIONS: Polymer-free DESs are as safe and effective as durable polymer DES; however, there is no evidence of any additional benefits provided by this new technology. Copyright 2014 Elsevier Ireland Ltd. All rights reserved.METHODS: MEDLINE, Google Scholar, EMBASE and Cochrane databases were searched for RCTs comparing polymer-free to durable polymer DES. Safety endpoints at short-term (< 1 year) and long-term follow-up (>1-year) were: death, myocardial infarction (MI) and stent thrombosis (ST); main efficacy endpoints were: target lesion revascularization (TLR) and target vessel revascularization (TVR).RESULTS: Eight RCTs including 6178 patients were included. No significant differences in mortality were observed between polymer-free and durable polymer DESs at both short- and long-follow up (OR [95% CI] = 0.79 [0.58-1.08], p = 0.14; and 0.80 [0.58-1.10], p = 0.17 respectively); polymer free and durable polymer DESs provided comparable short and long-term MI rates; at short-term: OR [95% CI] = 1.13 [0.83-1.54], p = 0.44 and at long-term: OR [95% CI] = 1.27 [0.87-1.85], p = 0.22. Similarly, these two different devices proved equally effective in regards to ST, TLR and TVR over the short and long follow-up period.All authors: Angelini P, Buffon A, Cortese B, de Boer MJ, Dias S, Kandzari D, Kelm M, Kowalewski M, Kubica J, Lansky A, Navarese EP, Suryapranata H, Torguson R, Waksman R, Wojakowski WFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-11-11
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Journal Article MedStar Authors Catalog Article 24529148 Available 24529148

BACKGROUND: The efficacy and safety of polymer-free drug-eluting stents (DESs) in clinical practice is currently subject of debate; randomized trials (RCTs) conducted so far provided conflicting results or were underpowered to definitively address this question; we aimed to investigate the efficacy and safety profile of polymer-free vs. durable polymer DES by a comprehensive meta-analysis of RCTs.

CONCLUSIONS: Polymer-free DESs are as safe and effective as durable polymer DES; however, there is no evidence of any additional benefits provided by this new technology. Copyright 2014 Elsevier Ireland Ltd. All rights reserved.

METHODS: MEDLINE, Google Scholar, EMBASE and Cochrane databases were searched for RCTs comparing polymer-free to durable polymer DES. Safety endpoints at short-term (< 1 year) and long-term follow-up (>1-year) were: death, myocardial infarction (MI) and stent thrombosis (ST); main efficacy endpoints were: target lesion revascularization (TLR) and target vessel revascularization (TVR).

RESULTS: Eight RCTs including 6178 patients were included. No significant differences in mortality were observed between polymer-free and durable polymer DESs at both short- and long-follow up (OR [95% CI] = 0.79 [0.58-1.08], p = 0.14; and 0.80 [0.58-1.10], p = 0.17 respectively); polymer free and durable polymer DESs provided comparable short and long-term MI rates; at short-term: OR [95% CI] = 1.13 [0.83-1.54], p = 0.44 and at long-term: OR [95% CI] = 1.27 [0.87-1.85], p = 0.22. Similarly, these two different devices proved equally effective in regards to ST, TLR and TVR over the short and long follow-up period.

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