1. Safety and efficacy of degradable vs. permanent polymer drug-eluting stents: A meta-analysis of 18,395 patients from randomized trials
- Author
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Yuqing Wang, Huanyun Liu, Yuanlin Luo, Shijian Liu, Lan Huang, Lufeng Li, Fangjuan Wang, and Xiaohui Zhao
- Subjects
Drug ,medicine.medical_specialty ,Polymers ,medicine.medical_treatment ,media_common.quotation_subject ,Late loss ,Revascularization ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Absorbable Implants ,medicine ,Humans ,Myocardial infarction ,Stent thrombosis ,Randomized Controlled Trials as Topic ,media_common ,business.industry ,Stent ,Drug-Eluting Stents ,medicine.disease ,Surgery ,Treatment Outcome ,Meta-analysis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Degradable polymer drug-eluting stents (DP-DES) represent a promising strategy to improve the delayed healing and hypersensitive reaction in the vessel. However, the efficacy and safety of DP-DES vs. permanent polymer drug-eluting stents (PP-DES) are less well defined. The aim of this meta-analysis was to compare the total, short ( 1year) term outcomes of DP-DES vs. PP-DES. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized clinical trials to compare any of approved DP- and PP-DES. Efficacy endpoints were target-lesion revascularization (TLR) and in-stent late loss (ISLL). Safety endpoints were death, myocardial infarction (MI), and composite of definite and probable stent thrombosis (ST). Results The meta-analysis included 19 RCTs (n=18,395) with interesting results. As compared with DES, there was a significantly reduced very late ST (OR [95% CI]=0.42 [0.24–0.77], p=0.852) and ISLL (OR [95% CI]=−0.07 [−0.12–0.02], p=0.000) in DP-DES patients. However, there were no differences between DP-DES and PP-DES for other safety and efficiency outcomes, except that the stratified analysis showed a significant decreased TLR with DP-DES as compared to paclitaxel-eluting stent (OR [95% CI]=0.41 [0.20–0.81], p=0.457). Conclusions DP-DES are more effective in reducing very late ST and ISLL, as well as comparable to PP-DES with regard to death, TLR and MI. Further large RCTs with long-term follow-up are warranted to better define the relative merits of DP-DES.
- Published
- 2014
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