Title

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

Authors

Waqas Ullah, Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Mohamed Zghouzi, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Bachar Ahmad, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Abdul-Rahman M. Suleiman, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Salman Zahid, Department of Cardiology, Rochester Regional Health, Rochester, New York, USA.
Mohammed Faisaluddin, Department of Cardiology, Rochester Regional Health, Rochester, New York, USA.
Mukhlis Alabdalrazzak, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Yasar Sattar, Department of Cardiology, Icahn School of Medicine at Mount Sinai Elmhurst Hospital, New York, New York, USA.
Ankur Kalra, Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Samir Kapadia, Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
David L. Fischman, Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Emmanouil S. Brilakis, Department of Cardiology, Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
Mamas A. Mamas, Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
M Chadi Alraies, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.

Department

Cardiology

Document Type

Article

Publication Title

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

Abstract

INTRODUCTION: The relative safety and efficacy of polymer-free (PF) versus polymer-coated (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 drugs mirrored the net estimates for all outcomes with a few exceptions. A sensitivity and meta-regression analysis showed no influence of single-study and duration of antiplatelet therapy on pooled outcomes. CONCLUSION: In patients presenting with angina or ACS, PF-DES might be favored due to lower all-cause mortality and equal risk of ischemic adverse cardiovascular and major bleeding events compared with PC-DES.

DOI

10.1002/ccd.29953

Publication Date

9-13-2021

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