Biodegradable polymer biolimus-eluting stent versus durable polymer everolimus-eluting stent in patients with acute myocardial infarction

Lee, Hyun Jong; Park, Taek Kyu; Song, Young Bin; Choi, Young Jin; Yu, Cheol Woong; Yang, Jeong Hoon; Hahn, Joo Yong; Choi, Seung Hyuk; Choi, Rak Kyeong; Choi, Jin Ho; Park, Jin Sik; Kim, Je Sang; Kim, Tae Hoon; Jang, Ho-Jun; Lee, Sang Hoon; Shim, Won Heum; Roh, Young Moo; Gwon, Hyeon Cheol

doi:10.1016/j.ijcard.2015.01.036

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…[18] Another study involving data from the Korea Acute Myocardial Infarction Registry (KAMIR) including a total number of 3359 patients with acute MI showed BP-SES to be noninferior to second-generation DP-DES during a follow-up of 2 years. [19] Recently, even Pandya et al [20] showed no significant differences between BP-DES and second generation DP-DES.…”

Section: Discussionmentioning

confidence: 99%

Adverse cardiovascular events associated with biodegradable polymer drug-eluting stents and durable polymer everolimus-eluting stents

et al. 2017

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Background:Controversies have been observed among network meta-analyses comparing biodegradable polymer drug-eluting stents (BP-DES) with durable polymer drug-eluting stents (DP-DES). We aimed to compare the adverse cardiovascular events associated with BP-DES and durable polymer everolimus-eluting stents (DP-EES) using a large number of patients obtained from randomized controlled trials (RCTs).Methods:Electronic databases were searched for randomized trials comparing BP-DES with DP-EES. Adverse cardiovascular outcomes observed between 6 months and 3 years were considered as the clinical endpoints in this analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and the pooled analyses were performed with RevMan 5.3 software. All authors had full access to the data, and they have read and agreed to the manuscript as written.Results:Ten trials involving a total number of 13,218 patients (7451 patients treated by BP-DES and 5767 patients treated by DP-EES) were included. No significant difference was observed when analyzing mortality and myocardial infarction between BP-DES and DP-EES with OR 1.08, 95% CI 0.87–1.34, P = .47 and OR 1.04, 95% CI 0.84–1.28, P = .72 respectively. Target vessel revascularization, target lesion revascularization, major adverse cardiac events, and stroke were also not significantly different with OR 1.11, 95% CI 0.92–1.33, P = .28; OR 1.11, 95% CI 0.94–1.33, P = .22; OR 1.12, 95% CI 0.99–1.27; P = .07; and OR 1.13, 95% CI 0.69–1.84; P = .62 respectively. In addition, total stent thrombosis (ST) was similarly reported between BP-DES and DP-EES with OR 0.85, 95% CI 0.59–1.21; P = .37. However, even if BP-DES were associated with a higher rate of definite ST with OR 1.69, 95% CI 0.92–3.08, P = .09 and DP-EES were associated with a higher rate of probable ST with OR 0.67, 95% CI 0.38–1.17, P = .16, these results were not statistically significant.Conclusions:Between 6 months and 3 years, BP-DES were similar in terms of cardiovascular outcomes compared to DP-EES. However, further long-term follow-up research is recommended.

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Section: Discussionmentioning

confidence: 99%

Adverse cardiovascular events associated with biodegradable polymer drug-eluting stents and durable polymer everolimus-eluting stents

et al. 2017

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“…After reading the full texts, 28 articles about ACS remained, with 20 articles including chronic and ACS. Finally, 8 articles, with 7 RCTs, comparing BP-DES and DP-DES in patients with ACS were identified and included in the qualitative and quantitative analyses 19–26. The follow-up duration ranged from 1 year to 5 years (online supplementary table 1 and online supplementary material 2).…”

Section: Resultsmentioning

confidence: 99%

Comparison of biodegradable and durable polymer drug-eluting stents in acute coronary syndrome: a meta-analysis

Yuan

et al. 2022

BMJ Open

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ObjectiveTo compare the safety and effectiveness between biodegradable polymer drug-eluting stents (BP-DES) and durable polymer drug-eluting stents (DP-DES) in patients with acute coronary syndrome (ACS).DesignMeta-analysis of randomised controlled trials (RCTs).Primary and secondary outcome measuresMajor adverse cardiovascular events (MACEs) were considered the primary endpoint. Efficacy endpoints included target vessel revascularisation (TVR) and target lesion revascularisation (TLR). Safety endpoints included all-cause death, cardiac death, target vessel myocardial infarction and stent thrombosis (ST).MethodsWe searched PubMed, Medline, Embase and the Cochrane Controlled Register of Trials for comparative studies of BP-DES and DP-DES in patients with ACS from January 2000 to July 2021. Statistical pooling was performed to estimate incidence using a random-effects model with generic inverse-variance weighting. Risk estimates were computed with 95% CIs.ResultsEight articles with seven RCTs that compared BP-DES and DP-DES in patients with ACS were identified and included in the qualitative and quantitative analyses. There was no difference in the baseline characteristics, except for the number of smoking patients (OR: 1.13, 95% CI 1.03 to 1.24; p=0.008, I2=29%), which was significantly lower in the BP-DES group. The meta-analysis demonstrated that MACEs, efficacy endpoints and safety endpoints were similar between the groups at 1 year. However, the incidence of total ST was signiﬁcantly different between the BP-DES and DP-DES groups in the follow-up period (p=0.0001). Further analysis showed a statistically significant difference in MACEs (OR: 0.71, 95% CI 0.57 to 0.88; p=0.002, I2=0 %), TLR (OR: 0.71, 95% CI 0.51 to 1.01; p=0.05, I2=0%), TVR (OR: 0.70, 95% CI 0.52 to 0.94; p=0.002, I2=15%), total ST incidence (OR: 0.59, 95% CI 0.46 to 0.77; p=0.0001, I2=48%) and ST incidence (OR: 0.63, 95% CI 0.47 to 0.85; p=0.002, I2=0%) over 2 years.ConclusionThis meta-analysis revealed that both stent types demonstrated excellent safety and efficacy profiles at 12 months. However, a slight increase in MACEs, TLR, TVR and ST incidence was observed in the DP-DES group over the 2-year follow-up period, suggesting that BP-DES may be more favourable when treating patients with ACS.Trial registration numberNCT00389220.

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“…Randomised studies have recently shown non-inferiority of BVS such as the bioresorbable ABSORB everolimus-eluting polymer scaffold compared to second generation DES, but with trends favouring DES due to stent thrombosis [49]. The biodegradable biolimus-eluting polymer stent has been trialled in acute coronary syndromes and was also non-inferior in efficacy and safety [50]. Bioresorbable metal alloy stents were initially disappointing with high rates of target lesion revascularisation, but the SYNERGY stent and the DREAMS 2G stent have similar rates to DES at less than 10% at two years [51,52].…”

Section: Stent Typementioning

confidence: 99%

Contemporary Management of ST-Elevation Myocardial Infarction

Dind

Allahwala

Asrress

et al. 2017

Heart, Lung and Circulation

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Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority. Ongoing trials will provide more information on the role of non-culprit lesion PCI, bioresorbable vascular scaffolds, mechanical devices in persistent ischaemia and early automatic implantable cardioverter-defibrillators for inducible ventricular tachycardia.

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Biodegradable polymer biolimus-eluting stent versus durable polymer everolimus-eluting stent in patients with acute myocardial infarction

Cited by 4 publications

References 35 publications

Adverse cardiovascular events associated with biodegradable polymer drug-eluting stents and durable polymer everolimus-eluting stents

Adverse cardiovascular events associated with biodegradable polymer drug-eluting stents and durable polymer everolimus-eluting stents

Comparison of biodegradable and durable polymer drug-eluting stents in acute coronary syndrome: a meta-analysis

Contemporary Management of ST-Elevation Myocardial Infarction

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