Comparison of long-term clinical outcomes of bioabsorbable polymer versus durable polymer drug-eluting stents: a systematic review and meta-analysis

• Published in: The Egyptian heart journal 2024-07, Vol.76 (1), p.91-16, Article 91
• Main Authors: Rehman, Abdur, Ahmed, Ifra Eeman, Nouman, Ahmed, Irfan, Rabia, Rehman, Qareeha, Syed, Abdul Rehman Shah, Zakir, Syeda Javeria, Mehdi, Samar, Khosa, Maha Mushtaq, Kumar, Satesh, Khatri, Mahima, Samiullah, F. N. U., Mohamad, Tamam, Varrassi, Giustino
• Format: Article
• Language: English
• Subjects: Angioplasty; Bioabsorbable polymer BP; Cardiology; Clinical trials; Comparative analysis; Drug-eluting stent; Durable polymer DP; Heart; Heart attack; Heart attacks; Ischemia; Medicine; Medicine & Public Health; Meta-analysis; Patient outcomes; Polymer industry; Polymers; Review; Stainless steel; Statistical analysis; Stent (Surgery); Stents; Thrombosis
• ISSN: 2090-911X; 1110-2608; 2090-911X
• DOI: 10.1186/s43044-024-00522-1

Background One million individuals in the USA die from acute myocardial infarction (MI), which currently affects 3 million people globally. The available data about the early and late outcomes of both biodegradable polymer drug-eluting stents (BP-DES) and durable polymer drug-eluting stents exhibit inconsistency. We performed a meta-analysis comparing the safety and efficacy of BP-DES with DP-DES. Methods PubMed, Google Scholar, EMBASE, Cochrane, Ovid Medline, and Clinical Trials.gov databases were used to find out studies comparing BP-DES to DP-DES. All the analyses used the random-effects model. Results A total of 18 studies were incorporated in this meta-analysis that involved 28,874 patients, out of which 11,997 received the BP Stent, and the rest of 16,578 received the DP stent. Thorough analyses revealed that the risk of all-cause death was significantly higher in the BP-DES group (5.4% vs 2.7%) (RR 1.22, p 0.02) for two years or less than two-year follow-up. For studies with more than two years of follow-up, all-cause death was 9.07% (599/6603) in BP-DES and 9.47% (531/5602) in the DP-DES group but failed to achieve statistically significant levels (RR 0.97, p 0.58). Conclusions The study revealed no clinically significant ( P value was > 0.05) differences in all-cause death, cardiac death, target lesion revascularization (TLR), late stent thrombosis, device-oriented composite endpoint/target lesion failure (DOCE/TLF), myocardial infarction (MI), target vessel MI, target vessel revascularization (TVR), target vessel infarction (TVI) between BP-DES and DP-DES for more than two years of follow-up. Additionally, all-cause death was only outcomes which found to have a statistically significant difference for less than two years of follow-up, while remaining were statistically non-significant. Article highlights BP-DES results in a higher all-cause death rate over follow-up periods of < 2 years compared to DP-DES. There are no appreciable clinical differences between the two types of stents for follow-up periods longer than 2 years for BP-DES and DP-DES.