Objective: Biocompatible polymer everolimus-eluting stents (EES) are associated with risk of stent thrombosis (ST); biodegradable polymer drug-eluting stents (BP-DES) were designed to reduce these risks. However, the long-term benefits are not completely clear.
Method: We undertook a meta-analysis of randomized studies identified in systematic searches of MEDLINE, EMBASE, and the Cochrane Database. Primary outcome was the risk of ST.
Results: Twelve studies (11,692 patients) were included. Overall, compared with EES, BP-DES were associated with a broadly equivalent risk of definite and probable ST (OR, 0.91; 95% CI, 0.55 to 1.50; P = 0.71; I2 = 0.0%), early ST (OR, 2.25; 95% CI, 0.78 to 6.47; P = 0.13; I2 = 0.0%), late ST (OR, 3.57; 95% CI, 0.42 to 30.58; P = 0.25; I2 = 0.0%) and very late ST (OR, 0.50; 95% CI, 0.05 to 5.52; P = 0.57). Meanwhile, there was no significant difference in all-cause mortality (OR, 1.07; 95% CI, 0.86 to 1.32; P = 0.54; I2 = 0.0%), myocardial infarction (OR, 1.07; 95% CI, 0.88 to 1.30; P = 0.47; I2 = 0.0%), target vessel revascularization (OR, 1.02; 95% CI, 0.86 to 1.21; P = 0.80; I2 = 12.0%), and major adverse cardiac events (OR, 1.04; 95% CI, 0.93 to 1.16; P = 0.53; I2 = 0.0%). Furthermore, angiographic data showed that in-stent and in-segment late luminal loss were similar between the two groups.
Conclusions: Compared with biocompatible polymer EES, biodegradable polymer stents appear to have equivalent clinical benefits.
Keywords: Coronary artery disease; biodegradable polymer; everolimus-eluting stent; stent restenosis; stent thrombosis.