Safety and efficacy of the polymer-free and polymer-coated drug-eluting stents in patients undergoing percutaneous coronary intervention
| Autor: | Bachar Ahmad, Abdul-Rahman M. Suleiman, Ankur Kalra, Emmanouil S. Brilakis, Yasar Sattar, David L. Fischman, Mohamed Zghouzi, Mohammed Faisaluddin, Salman Zahid, Mukhlis Alabdalrazzak, Waqas Ullah, Mamas A. Mamas, Samir R. Kapadia, M. Chadi Alraies |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Polymers medicine.medical_treatment Coronary Artery Disease Prosthesis Design Angina Percutaneous Coronary Intervention Risk Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Myocardial infarction Stroke business.industry Percutaneous coronary intervention Drug-Eluting Stents General Medicine Odds ratio medicine.disease Treatment Outcome Drug-eluting stent Cardiology Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 98(6) |
| ISSN: | 1522-726X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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