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

摘要

BackgroundPolymer-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 methodsWe 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.ResultsNo 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).ConclusionsOur findings showed that PF-DES and DP-DES confer equivalent safety and efficacy profiles, with similar rates of stent thrombosis.