Efficacy and safety of biodegradable polymer sirolimus-eluting stents versus durable polymer drug-eluting stents: A meta-analysis of randomized trials.

BACKGROUND: A meta-analysis was performed to investigate the safety and efficacy of biodegradable polymer sirolimus-eluting stents (BP-SESs) compared with durable polymer drug-eluting stents (DP-DESs).

METHODS: Online databases, including PubMed, EMBASE and the Cochrane Library, were searched for randomized controlled trials that compared BP-SESs and DP-DESs and reported rates of overall and cardiac mortality, myocardial infarction (MI), stent thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR) and late lumen loss (LLL).

RESULTS: A total of 15 studies investigating 14,187 patients were included in the meta-analysis. The BP-SESs significantly reduced the risk of late ST (OR: 0.57; 95% CI: 0.33-0.98; p=0.04), very late ST (OR: 0.53; 95% CI: 0.29-0.97; p=0.04) and in-stent LLL (MD: -0.06, 95% CI: -0.11 to -0.01; p=0.01) compared with the DP-DESs but did not improve mortality (OR: 0.95; 95% CI: 0.81-1.11; p=0.52), cardiac mortality (OR: 0.89; 95% CI: 0.72-1.10; p=0.27), MI (OR: 0.90; 95% CI: 0.76-1.08; p=0.27), TLR (OR: 0.95; 95% CI: 0.81-1.11; p=0.51), TVR (OR: 0.96; 95% CI: 0.81-1.13; p=0.62) or in-segment LLL (MD: -0.03, 95% CI: -0.06-0.01; p=0.10).

CONCLUSIONS: In this meta-analysis of randomized controlled trials, the BP-SESs were superior to the DP-DESs in terms of late ST, very late ST and in-stent LLL. Further large randomized controlled trials with long-term follow-up are required to validate the benefits of BP-SESs.