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Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis.

Publication ,  Journal Article
Banach, M; Serban, M-C; Sahebkar, A; García-García, HM; Mikhailidis, DP; Martin, SS; Brie, D; Rysz, J; Toth, PP; Jones, SR; Hasan, RK ...
Published in: EuroIntervention
June 12, 2016

AIMS: Several studies have suggested good procedural and similar clinical outcomes between everolimus-eluting Absorb bioresorbable stents (BRS) versus conventional drug-eluting stents (DES), but the evidence is not definitive. Our aim was to perform a systematic review and meta-analysis to investigate the effects of BRS versus conventional drug-eluting and bare metallic stents on the cardiovascular endpoints and all-cause mortality. METHODS AND RESULTS: The follow-up in the included studies was up to 13 months. The following endpoints were evaluated: all-cause mortality, cardiac death, patient-oriented major adverse cardiac events (POCE), device-oriented major adverse cardiac events (DOCE), any-cause myocardial infarction (MI), target vessel MI (TVMI), target vessel revascularisation (TVR) and target lesion revascularisation (TLR). The results of 10 studies with 5,773 subjects showed a statistically significant increase in the risk of TVMI between BRS and conventional stents (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.03-2.05, p=0.032). None of the other differences reached statistical significance: all-cause mortality (OR: 0.67, 95% CI: 0.30-1.49, p=0.333), cardiac death (OR: 1.00, 95% CI: 0.47-2.12, p=0.996), POCE (OR: 0.91, 95% CI: 0.68-1.22, p=0.546), DOCE (OR: 1.12, 95% CI: 0.86-1.46, p=0.387), any-cause MI (OR: 1.34, 95% CI: 0.98-1.82, p=0.064), TVR (OR: 0.99, 95% CI: 0.73-1.33, p=0.934) and TLR (OR: 0.92, 95% CI: 0.66-1.29, p=0.641). Similar results were observed after restricting the meta-analysis to the comparison of BRS vs. EES. CONCLUSIONS: Our meta-analysis suggests a significantly higher risk of TVMI with BRS compared with conventional stents and no significant differences in the rates of occurrence of the other outcomes during one-year follow-up. Further studies with larger samples sizes, longer follow-up, different clinical scenarios and more complex lesions are required to confirm or refute our findings.

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Published In

EuroIntervention

DOI

EISSN

1969-6213

Publication Date

June 12, 2016

Volume

12

Issue

2

Start / End Page

e175 / e189

Location

France

Related Subject Headings

  • Treatment Outcome
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Drug-Eluting Stents
  • Coronary Thrombosis
  • Absorbable Implants
  • 3201 Cardiovascular medicine and haematology
  • 0104 Statistics
 

Citation

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Banach, M., Serban, M.-C., Sahebkar, A., García-García, H. M., Mikhailidis, D. P., Martin, S. S., … Serruys, P. W. (2016). Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis. EuroIntervention, 12(2), e175–e189. https://doi.org/10.4244/EIJY16M06_02
Banach, Maciej, Maria-Corina Serban, Amirhossein Sahebkar, Hector M. García-García, Dimitri P. Mikhailidis, Seth S. Martin, Daniel Brie, et al. “Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis.EuroIntervention 12, no. 2 (June 12, 2016): e175–89. https://doi.org/10.4244/EIJY16M06_02.
Banach M, Serban M-C, Sahebkar A, García-García HM, Mikhailidis DP, Martin SS, et al. Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis. EuroIntervention. 2016 Jun 12;12(2):e175–89.
Banach, Maciej, et al. “Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis.EuroIntervention, vol. 12, no. 2, June 2016, pp. e175–89. Pubmed, doi:10.4244/EIJY16M06_02.
Banach M, Serban M-C, Sahebkar A, García-García HM, Mikhailidis DP, Martin SS, Brie D, Rysz J, Toth PP, Jones SR, Hasan RK, Mosteoru S, Al Rifai M, Pencina MJ, Serruys PW. Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: a systematic review and meta-analysis. EuroIntervention. 2016 Jun 12;12(2):e175–e189.

Published In

EuroIntervention

DOI

EISSN

1969-6213

Publication Date

June 12, 2016

Volume

12

Issue

2

Start / End Page

e175 / e189

Location

France

Related Subject Headings

  • Treatment Outcome
  • Percutaneous Coronary Intervention
  • Myocardial Infarction
  • Humans
  • Drug-Eluting Stents
  • Coronary Thrombosis
  • Absorbable Implants
  • 3201 Cardiovascular medicine and haematology
  • 0104 Statistics