Safety and efficacy of the polymer‐free and polymer‐coated drug‐eluting stents in patients undergoing percutaneous coronary intervention

Abstract

Introduction:The relative safety and efficacy of polymer-free (PF) versus polymercoated (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 Waqas Ullah and Mohamed Zghouzi contributed equally to this study.

Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

“…Numerous studies have examined the causes of these post-DES implant delayed events and found that stent features and fundamental health factors, such as older age, diabetes, and acute manifestations, may operate as independent risk factors of late stent consequences. Ullah et al [ 43 ] suggested that patients who received either PF-DES or PC-DES appeared to have a similar risk of major adverse cardiovascular events (MACEs), strokes, MI, stent thrombosis, and the need for target lesion and vessel revascularization (TLR and TVR) [ 43 ]. Their overall results were consistent across multiple subgroup analyses based on the length of follow-up (one month to 10 years), the presence of diabetes mellitus (DM), the clinical presentation (angina vs. STEMI), and the kind of drug-eluting PF stents used.…”