Ultrathin-strut biodegradable polymer versus durable polymer drug-eluting stents: a meta-analysis

Monjur, M. R., Said, C., Bamford, P., Parkinson, M., Szirt, R. and Ford, T. (2020) Ultrathin-strut biodegradable polymer versus durable polymer drug-eluting stents: a meta-analysis. Open Heart, 7, e001394. (doi: 10.1136/openhrt-2020-001394) (PMID:33046595) (PMCID:PMC7552849)

Abstract

Objectives: Determine whether an ultrathin biodegradable polymer sirolimus-eluting stent (‘Orsiro’—BP-SES) has clinical benefits over second-generation durable polymer drug-eluting stents (DP-DES). Methods: We conducted a prospective systematic review and meta-analysis of randomised clinical trials comparing Orsiro BP-SES against DP-DES (PROSPERO Registration: CRD42019147136). The primary outcome was target lesion failure (TLF): composite of cardiac death, target vessel myocardial infarction (TVMI) and clinically indicated target lesion revascularisation (TLR)) evaluated at the longest available follow-up. Results: Nine trials randomised 11 302 patients to either Orsiro BP-SES or DP-DES. At mean weighted follow-up of 2.8 years, the primary outcome (TLF) occurred in 501 of 6089 (8.2%) participants with BP-SES compared with 495 of 5213 (9.5%) participants with DP-DES. This equates to an absolute risk reduction of 1.3% in TLF in favour of Orsiro BP-SES (OR 0.82; 95% CI 0.69 to 0.98; p=0.03). This was driven by a reduction in TVMI (OR 0.80; 95% CI 0.65 to 0.98; p=0.03). There were no significant differences in other clinical endpoints: cardiac death, TLR and stent thrombosis. Conclusion: The Orsiro BP-SES shows promising clinical outcomes in patients undergoing percutaneous coronary intervention compared with contemporary second-generation DES at a short to medium term follow-up. More research is warranted to evaluate performance over a longer follow-up period and in different clinical and lesion subsets.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Thomas
• Authors: Monjur, M. R., Said, C., Bamford, P., Parkinson, M., Szirt, R., and Ford, T.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Open Heart
• Publisher: BMJ Publishing Group
• ISSN: 2053-3624
• ISSN (Online): 2053-3624
• Published Online: 12 October 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Open Heart 7:e001394
• Publisher Policy: Reproduced under a Creative Commons License