Long-term outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer everolimus-eluting stents: A meta-analysis of randomized controlled trials

• Published in: International journal of cardiology Vol. 223; pp. 1066 - 1071
• Main Authors: Sakurai, Ryota, Burazor, Ivana, Bonneau, Heidi N, Kaneda, Hideaki
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.11.2016
• Subjects: Absorbable Implants; Biodegradable polymer biolimus-eluting stent; Cardiovascular; Coronary Artery Disease - surgery; Drug-Eluting Stents; Durable polymer everolimus-eluting stent; Humans; Long Term Adverse Effects - diagnosis; Long Term Adverse Effects - epidemiology; Long Term Adverse Effects - etiology; Meta-analysis; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - methods; Randomized controlled trial; durable polymer everolimus-eluting stent; meta-analysis; biodegradable polymer biolimus-eluting stent; randomized controlled trial; Durable polymer everolimus-eluting stent; Biodegradable polymer biolimus-eluting stent; Randomized controlled trial; Meta-analysis
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2016.07.078

Abstract Background Both biodegradable polymer biolimus-eluting stents (BP-BES) and biocompatible durable polymer everolimus-eluting stents (DP-EES) have been developed to decrease the risk of late adverse events. However, their efficacy and safety beyond 1 year after stent deployment still remain controversial. Methods We conducted a meta-analysis on randomized controlled trials (RCT) comparing BP-BES with DP-EES in patients undergoing percutaneous coronary intervention in long-term follow up (beyond 1 year), and compared the pooled estimates with those in mid-term follow up (within 1 year). Results Eight RCT were included in this meta-analysis. The risks in BP-BES versus DP-EES of death (odds ratio (OR): 1.06, 95% confidence interval (CI): 0.86–1.31, p = 0.557 for long-term; OR: 1.09, 95% CI: 0.76–1.56, p = 0.645 for mid-term), myocardial infarction (OR: 1.06, 95% CI: 0.84–1.35, p = 0.628 for long-term; OR: 1.04, 95% CI: 0.81–1.33, p = 0.778 for mid-term) and definite or probable stent thrombosis (OR: 0.89, 95% CI: 0.51–1.57, p = 0.695 for long-term; OR: 1.36, 95% CI: 0.66–2.81, p = 0.400 for mid-term) were comparable in each follow up, respectively. In contrast, the risk of target vessel revascularization (TVR) tended to be higher in BP-BES as compared to DP-EES in long-term follow up (OR: 1.15, 95% CI: 0.97–1.37, p = 0.098 for long-term; OR: 1.09, 95% CI: 0.87–1.36, p = 0.447 for mid-term). Conclusions Although the overall clinical outcomes were similar between BP-BES and DP-EES, BP-BES may be associated with higher risk of TVR up to 3 years after stent deployment compared with DP-EES. Further studies are warranted in larger populations of patients during longer-term follow up.