TY - JOUR
T1 - Safety and efficacy of the polymer-free and polymer-coated drug-eluting stents in patients undergoing percutaneous coronary intervention
AU - Ullah, Waqas
AU - Zghouzi, Mohamed
AU - Ahmad, Bachar
AU - Suleiman, Abdul Rahman M.
AU - Zahid, Salman
AU - Faisaluddin, Mohammed
AU - Alabdalrazzak, Mukhlis
AU - Sattar, Yasar
AU - Kalra, Ankur
AU - Kapadia, Samir
AU - Fischman, David L.
AU - Brilakis, Emmanouil S.
AU - Mamas, Mamas A.
AU - Alraies, M. Chadi
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2021/11/15
Y1 - 2021/11/15
N2 - Introduction: The relative safety and efficacy of polymer-free (PF) versus polymer-coated (PC) drug-eluting stents (DES) in patients with angina or acute coronary syndrome (ACS) undergoing percutaneous coronary intervention has received limited study. Method: Digital databases were queried to identify relevant studies. Major adverse cardiovascular events (MACE) and secondary outcomes were compared using a random effect model to calculate unadjusted odds ratios (OR). Results: A total of 28 studies consisting of 23,198 patients were included in the final analysis. On pooled analysis, there was no significant difference in the odds of MACE (OR 0.98, 95% CI 0.91–1.08) and major bleeding (OR 0.87, 95% CI 0.61–1.24) between patients undergoing PF-DES versus PC-DES. Similarly, the odds of myocardial infarction, stroke, stent thrombosis, cardiovascular mortality and need for target vessel revascularization was similar between the two groups. PF-DES was favored due to significantly lower odds of non-cardiac death (OR 0.78, 95% CI 0.68–89) and all-cause mortality (OR 0.87, 95% CI 0.80–0.95), but had a higher need for target lesion revascularization (OR 1.2, 95% CI 1.02–1.42). A subgroup analysis based on follow up duration, clinical presentation, presence of diabetes and class of eluting drugs mirrored the net estimates for all outcomes with a few exceptions. A sensitivity and meta-regression analysis showed no influence of single-study and duration of antiplatelet therapy on pooled outcomes. Conclusion: In patients presenting with angina or ACS, PF-DES might be favored due to lower all-cause mortality and equal risk of ischemic adverse cardiovascular and major bleeding events compared with PC-DES.
AB - Introduction: The relative safety and efficacy of polymer-free (PF) versus polymer-coated (PC) drug-eluting stents (DES) in patients with angina or acute coronary syndrome (ACS) undergoing percutaneous coronary intervention has received limited study. Method: Digital databases were queried to identify relevant studies. Major adverse cardiovascular events (MACE) and secondary outcomes were compared using a random effect model to calculate unadjusted odds ratios (OR). Results: A total of 28 studies consisting of 23,198 patients were included in the final analysis. On pooled analysis, there was no significant difference in the odds of MACE (OR 0.98, 95% CI 0.91–1.08) and major bleeding (OR 0.87, 95% CI 0.61–1.24) between patients undergoing PF-DES versus PC-DES. Similarly, the odds of myocardial infarction, stroke, stent thrombosis, cardiovascular mortality and need for target vessel revascularization was similar between the two groups. PF-DES was favored due to significantly lower odds of non-cardiac death (OR 0.78, 95% CI 0.68–89) and all-cause mortality (OR 0.87, 95% CI 0.80–0.95), but had a higher need for target lesion revascularization (OR 1.2, 95% CI 1.02–1.42). A subgroup analysis based on follow up duration, clinical presentation, presence of diabetes and class of eluting drugs mirrored the net estimates for all outcomes with a few exceptions. A sensitivity and meta-regression analysis showed no influence of single-study and duration of antiplatelet therapy on pooled outcomes. Conclusion: In patients presenting with angina or ACS, PF-DES might be favored due to lower all-cause mortality and equal risk of ischemic adverse cardiovascular and major bleeding events compared with PC-DES.
KW - ACS
KW - PC
KW - PF
KW - acute coronary syndrome
KW - drug-eluting stent
KW - polymer coated
KW - polymer free
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U2 - 10.1002/ccd.29953
DO - 10.1002/ccd.29953
M3 - Article
C2 - 34510705
AN - SCOPUS:85114883083
SN - 1522-1946
VL - 98
SP - E802-E813
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -