Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients

Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients

Background: Permanent polymer drug eluting stents (PP-DES) may induce inflammation of the vessel wall due to the existence of the polymer, which may delay intimal healing. Polymer-free DES (PF-DES) that eliminate the polymeric carrier may potentially lead to safer DES. However, the safety and effica...

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Autores principales: De-Wei Wu, Meng-Yue Yu, Hai-Yang Gao, Li Zhang, Fei Song, Xin-Yue Zhang, Yong-Jian Wu
Formato: article
Lenguaje:EN
Publicado: KeAi Communications Co., Ltd. 2015
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Medicine (General)
R5-920
Acceso en línea:https://doaj.org/article/cd83e1ccafaa4551b7e201e80154b806
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spelling oai:doaj.org-article:cd83e1ccafaa4551b7e201e80154b8062021-12-02T13:26:50ZPolymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients2095-882X10.1016/j.cdtm.2016.01.001https://doaj.org/article/cd83e1ccafaa4551b7e201e80154b8062015-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X16000025https://doaj.org/toc/2095-882XBackground: Permanent polymer drug eluting stents (PP-DES) may induce inflammation of the vessel wall due to the existence of the polymer, which may delay intimal healing. Polymer-free DES (PF-DES) that eliminate the polymeric carrier may potentially lead to safer DES. However, the safety and efficacy of PF-DES remains controversial. Methods: Randomized controlled trials comparing PF-DES with PP-DES were searched in online database including MEDLINE, Excerpta Medica Database (EMBASE) and Cochrane Library. Studies reporting late lumen loss (LLL), all-cause death, myocardial infarction (MI), target lesion revascularization (TLR) and late stent thrombosis (LST) were enrolled and quantitatively analyzed. Results: Ten studies enrolling 6575 patients were included in this meta-analysis. The PF-DES showed a benefit in reducing all-cause death (OR = 0.77, 95% CI: 0.61 to 0.98, P = 0.03) and long-term LLL (weighted mean difference (WMD) â0.16 mm, 95% CI: â0.22 to â0.11 mm, P < 0.001), while no superiority was found in reducing short-term LLL (WMD 0.03 mm, 95% CI: â0.07â0.13 mm, P = 0.57), MI (OR = 1.12, 95% CI: 0.19 to 23.18, P = 0.39), TLR (OR = 1.19, 95% CI: 0.42 to 3.38, P = 0.83) and LST (OR = 0.92, 95% CI: 0.05 to 5.71, P = 0.74). Conclusion: PF-DES showed benefits in reducing long-term LLL and mortality compared with PP-DES, but no superiority was found in short-term LLL, MI, TLR and LST. These findings provide a sound basis for the wide application of PF-DES in the future. Keywords: Drug eluting stent, Polymer-free DES, Meta-analysisDe-Wei WuMeng-Yue YuHai-Yang GaoLi ZhangFei SongXin-Yue ZhangYong-Jian WuKeAi Communications Co., Ltd.articleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 1, Iss 4, Pp 221-230 (2015)
institution DOAJ
collection DOAJ
language EN
topic Medicine (General)
R5-920
spellingShingle Medicine (General)
R5-920
De-Wei Wu
Meng-Yue Yu
Hai-Yang Gao
Li Zhang
Fei Song
Xin-Yue Zhang
Yong-Jian Wu
Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
description Background: Permanent polymer drug eluting stents (PP-DES) may induce inflammation of the vessel wall due to the existence of the polymer, which may delay intimal healing. Polymer-free DES (PF-DES) that eliminate the polymeric carrier may potentially lead to safer DES. However, the safety and efficacy of PF-DES remains controversial. Methods: Randomized controlled trials comparing PF-DES with PP-DES were searched in online database including MEDLINE, Excerpta Medica Database (EMBASE) and Cochrane Library. Studies reporting late lumen loss (LLL), all-cause death, myocardial infarction (MI), target lesion revascularization (TLR) and late stent thrombosis (LST) were enrolled and quantitatively analyzed. Results: Ten studies enrolling 6575 patients were included in this meta-analysis. The PF-DES showed a benefit in reducing all-cause death (OR = 0.77, 95% CI: 0.61 to 0.98, P = 0.03) and long-term LLL (weighted mean difference (WMD) â0.16 mm, 95% CI: â0.22 to â0.11 mm, P < 0.001), while no superiority was found in reducing short-term LLL (WMD 0.03 mm, 95% CI: â0.07â0.13 mm, P = 0.57), MI (OR = 1.12, 95% CI: 0.19 to 23.18, P = 0.39), TLR (OR = 1.19, 95% CI: 0.42 to 3.38, P = 0.83) and LST (OR = 0.92, 95% CI: 0.05 to 5.71, P = 0.74). Conclusion: PF-DES showed benefits in reducing long-term LLL and mortality compared with PP-DES, but no superiority was found in short-term LLL, MI, TLR and LST. These findings provide a sound basis for the wide application of PF-DES in the future. Keywords: Drug eluting stent, Polymer-free DES, Meta-analysis
format article
author De-Wei Wu
Meng-Yue Yu
Hai-Yang Gao
Li Zhang
Fei Song
Xin-Yue Zhang
Yong-Jian Wu
author_facet De-Wei Wu
Meng-Yue Yu
Hai-Yang Gao
Li Zhang
Fei Song
Xin-Yue Zhang
Yong-Jian Wu
author_sort De-Wei Wu
title Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
title_short Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
title_full Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
title_fullStr Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
title_full_unstemmed Polymer-free versus permanent polymer drug eluting stents in coronary artery disease: A meta-analysis of 10 RCTs with 6575 patients
title_sort polymer-free versus permanent polymer drug eluting stents in coronary artery disease: a meta-analysis of 10 rcts with 6575 patients
publisher KeAi Communications Co., Ltd.
publishDate 2015
url https://doaj.org/article/cd83e1ccafaa4551b7e201e80154b806
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