Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > Articles online first > The Journal of Cardiovascular Surgery 2020 Dec 14



Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca


Publication history
Per citare questo articolo



The Journal of Cardiovascular Surgery 2020 Dec 14

DOI: 10.23736/S0021-9509.20.11620-3


lingua: Inglese

Angiographic and clinical outcomes of patients implanted with ultrathin, biodegradable polymer sirolimus-eluting stents versus durable polymer drug-eluting stents for percutaneous coronary intervention: an updated meta-analysis based on randomized controlled trials

Chen LIAO 1, 2, Sen LIAO 3, Miaoweng LIU 2, Ruoxin XU 2, Jinhua PENG 1, Yiping WEI 1,Wenxiong ZHANG 1

1 Department of Cardio-Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China; 2 Jiangxi Medical College, Nanchang University, Nanchang, China; 3 FuZhou Medical College, Nanchang University, Nanchang, China


BACKGROUND: Whether sirolimus-eluting stents constituted with ultrathin-strut and biodegradable polymers (BP-SESs) can achieve a preferable effect over current drug-eluting stents with durable polymers (DP-DESs) remains highly controversial. The aim of this analysis based on randomized controlled trials (RCTs) was to detect the clinical and angiographic differences between ultrathin (defined as a strut thickness <70 μm) BP-SESs and DP-DESs.
METHODS/MATERIALS: We searched seven databases to identify eligible articles. Late lumen loss (LLL) and target lesion failure (TLF) were assessed as the primary endpoints for angiographic and clinical outcomes, respectively.
RESULTS: Nineteen articles containing thirteen RCTs with 14801 patients were analyzed. For the 9-month angiographic outcomes, similar results were discovered between BP-SESs and DP-DESs in terms of in-stent LLL (mean difference [MD]: -0.02[-0.05, 0.01], P=0.23), in-segment LLL (MD: -0.01[-0.04, 0.03], P=0.74), in-stent minimum lumen diameter (MLD) (MD: -0.01[-0.06, 0.04], P=0.72), in-segment MLD (MD: -0.01[-0.06, 0.05], P=0.75), in-stent diameter stenosis (DS) (MD: -1.10[-3.36, 1.15], P=0.34), in-segment DS (MD: -0.78[-1.97, 0.40], P=0.20), in-stent binary restenosis (BR) (risk ratio [RR]: 2.27[0.99, 5.21], P=0.05) and in-segment BR (RR: 1.46[0.78, 2.75], P=0.24). Regarding the 12-month clinical outcomes, there was a significant decrease in TLF and a trend of a lower incidence of target vessel failure (RR: 0.89[0.78,1.01], P=0.08), myocardial infarction (MI) and target vessel MI.
CONCLUSIONS: With similar angiographic results, BP-SESs appeared to be superior to DP-DESs with better clinical prognoses, especially for female patients, patients with STEMI and ACS and patients without diabetes. More high-quality randomized controlled trials are needed to confirm these results.

KEY WORDS: Meta-analysis; Biodegradable polymer; Durable polymer; Ultrathin; Percutaneous coronary intervention; Coronary artery disease

inizio pagina