Meta-analysis Comparing Bioresorbable Vs. Drug-eluting Stents

N King; C Wood; N A Smart

doi:10.1159/000477751

Abstract

Background: Some concerns have been raised about the occurrence of acute, late or very late stent thrombosis with drug eluting stents (DES) [1]. To address this bioresorbable stents (BRS) have been introduced; however, there are few studies comparing the efficacy of BRS vs. DES.

Objectives: The aim of this meta-analysis was to compare the effects of BRS vs. DES on a range of clinical outcomes.

Methods: To identify potential randomised clinical trials systematic searches were carried out in EMBASE, PubMed, Web of Science and the Cochrane Central Registry of Controlled Trials (CENTRAL) (until 24/02/2017) searching for “bioresorbable” and “drug eluting stent”. This was followed by a meta-analysis investigating device success (no use of an unassigned device), mortality, target lesion revascularisation (TLR), incidence of myocardial infarction (MI), target lesion failure (TLF), target vessel revascularisation (TVR), early thrombosis (equal to or less than 30 days), late thrombosis (>30 days), in segment late lumen loss (change in minimal lumen diameter post-procedure to 6-13 months) and minimum luminal diameter post-procedure (MLDPP) (in device).

Results: Seven studies involving 4914 participants were identified. There were no significant differences in the incidences of early thrombosis (odds ratio (OR) 1.67 [95% confidence interval (CI) 0.79-3.54, p=0.18]), late thrombosis (OR 1.11 [95% CI 0.51-2.42, p=0.8]), mortality, MI, TLR, TLF, and TVR for BRS vs. DES. Device success (OR 0.16 [95% CI 0.08-0.31, p<0.00001]) and MLDPP (in device) (mean difference (MD) -0.11mm [95% CI -0.14-0.07, p<00001]) were significantly lower and in segment late lumen loss (MD 0.04mm [95% CI 0.00-0.07, p=0.04) was significantly higher for BRS.

Conclusions: BRS use did not reduce the incidence of thrombosis or revascularisation and was associated with lower device success, higher in segment late lumen loss and lower MLDPP (in device). Reference Brie D et al (2016) Int J Cardiol. 215, 47-59.

Original language	English
Pages	276-276
DOIs	https://doi.org/10.1159/000477751
Publication status	Published - 7 Jul 2017
Event	22nd World Congress on Heart Disease - Canada Duration: 14 Jul 2017 → 16 Jul 2017

Other

Other	22nd World Congress on Heart Disease
City	Canada
Period	14/07/17 → 16/07/17

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Cite this

@conference{3fc755380fb2491f9063089b60626e84,

title = "Meta-analysis Comparing Bioresorbable Vs. Drug-eluting Stents",

abstract = "Background: Some concerns have been raised about the occurrence of acute, late or very late stent thrombosis with drug eluting stents (DES) [1]. To address this bioresorbable stents (BRS) have been introduced; however, there are few studies comparing the efficacy of BRS vs. DES. Objectives: The aim of this meta-analysis was to compare the effects of BRS vs. DES on a range of clinical outcomes. Methods: To identify potential randomised clinical trials systematic searches were carried out in EMBASE, PubMed, Web of Science and the Cochrane Central Registry of Controlled Trials (CENTRAL) (until 24/02/2017) searching for {\textquotedblleft}bioresorbable{\textquotedblright} and {\textquotedblleft}drug eluting stent{\textquotedblright}. This was followed by a meta-analysis investigating device success (no use of an unassigned device), mortality, target lesion revascularisation (TLR), incidence of myocardial infarction (MI), target lesion failure (TLF), target vessel revascularisation (TVR), early thrombosis (equal to or less than 30 days), late thrombosis (>30 days), in segment late lumen loss (change in minimal lumen diameter post-procedure to 6-13 months) and minimum luminal diameter post-procedure (MLDPP) (in device). Results: Seven studies involving 4914 participants were identified. There were no significant differences in the incidences of early thrombosis (odds ratio (OR) 1.67 [95\% confidence interval (CI) 0.79-3.54, p=0.18]), late thrombosis (OR 1.11 [95\% CI 0.51-2.42, p=0.8]), mortality, MI, TLR, TLF, and TVR for BRS vs. DES. Device success (OR 0.16 [95\% CI 0.08-0.31, p<0.00001]) and MLDPP (in device) (mean difference (MD) -0.11mm [95\% CI -0.14-0.07, p<00001]) were significantly lower and in segment late lumen loss (MD 0.04mm [95\% CI 0.00-0.07, p=0.04) was significantly higher for BRS. Conclusions: BRS use did not reduce the incidence of thrombosis or revascularisation and was associated with lower device success, higher in segment late lumen loss and lower MLDPP (in device). Reference Brie D et al (2016) Int J Cardiol. 215, 47-59.",

author = "N King and C Wood and Smart, \{N A\}",

year = "2017",

month = jul,

day = "7",

doi = "10.1159/000477751",

language = "English",

pages = "276--276",

note = "22nd World Congress on Heart Disease ; Conference date: 14-07-2017 Through 16-07-2017",

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TY - CONF

T1 - Meta-analysis Comparing Bioresorbable Vs. Drug-eluting Stents

AU - King, N

AU - Wood, C

AU - Smart, N A

PY - 2017/7/7

Y1 - 2017/7/7

N2 - Background: Some concerns have been raised about the occurrence of acute, late or very late stent thrombosis with drug eluting stents (DES) [1]. To address this bioresorbable stents (BRS) have been introduced; however, there are few studies comparing the efficacy of BRS vs. DES. Objectives: The aim of this meta-analysis was to compare the effects of BRS vs. DES on a range of clinical outcomes. Methods: To identify potential randomised clinical trials systematic searches were carried out in EMBASE, PubMed, Web of Science and the Cochrane Central Registry of Controlled Trials (CENTRAL) (until 24/02/2017) searching for “bioresorbable” and “drug eluting stent”. This was followed by a meta-analysis investigating device success (no use of an unassigned device), mortality, target lesion revascularisation (TLR), incidence of myocardial infarction (MI), target lesion failure (TLF), target vessel revascularisation (TVR), early thrombosis (equal to or less than 30 days), late thrombosis (>30 days), in segment late lumen loss (change in minimal lumen diameter post-procedure to 6-13 months) and minimum luminal diameter post-procedure (MLDPP) (in device). Results: Seven studies involving 4914 participants were identified. There were no significant differences in the incidences of early thrombosis (odds ratio (OR) 1.67 [95% confidence interval (CI) 0.79-3.54, p=0.18]), late thrombosis (OR 1.11 [95% CI 0.51-2.42, p=0.8]), mortality, MI, TLR, TLF, and TVR for BRS vs. DES. Device success (OR 0.16 [95% CI 0.08-0.31, p<0.00001]) and MLDPP (in device) (mean difference (MD) -0.11mm [95% CI -0.14-0.07, p<00001]) were significantly lower and in segment late lumen loss (MD 0.04mm [95% CI 0.00-0.07, p=0.04) was significantly higher for BRS. Conclusions: BRS use did not reduce the incidence of thrombosis or revascularisation and was associated with lower device success, higher in segment late lumen loss and lower MLDPP (in device). Reference Brie D et al (2016) Int J Cardiol. 215, 47-59.

AB - Background: Some concerns have been raised about the occurrence of acute, late or very late stent thrombosis with drug eluting stents (DES) [1]. To address this bioresorbable stents (BRS) have been introduced; however, there are few studies comparing the efficacy of BRS vs. DES. Objectives: The aim of this meta-analysis was to compare the effects of BRS vs. DES on a range of clinical outcomes. Methods: To identify potential randomised clinical trials systematic searches were carried out in EMBASE, PubMed, Web of Science and the Cochrane Central Registry of Controlled Trials (CENTRAL) (until 24/02/2017) searching for “bioresorbable” and “drug eluting stent”. This was followed by a meta-analysis investigating device success (no use of an unassigned device), mortality, target lesion revascularisation (TLR), incidence of myocardial infarction (MI), target lesion failure (TLF), target vessel revascularisation (TVR), early thrombosis (equal to or less than 30 days), late thrombosis (>30 days), in segment late lumen loss (change in minimal lumen diameter post-procedure to 6-13 months) and minimum luminal diameter post-procedure (MLDPP) (in device). Results: Seven studies involving 4914 participants were identified. There were no significant differences in the incidences of early thrombosis (odds ratio (OR) 1.67 [95% confidence interval (CI) 0.79-3.54, p=0.18]), late thrombosis (OR 1.11 [95% CI 0.51-2.42, p=0.8]), mortality, MI, TLR, TLF, and TVR for BRS vs. DES. Device success (OR 0.16 [95% CI 0.08-0.31, p<0.00001]) and MLDPP (in device) (mean difference (MD) -0.11mm [95% CI -0.14-0.07, p<00001]) were significantly lower and in segment late lumen loss (MD 0.04mm [95% CI 0.00-0.07, p=0.04) was significantly higher for BRS. Conclusions: BRS use did not reduce the incidence of thrombosis or revascularisation and was associated with lower device success, higher in segment late lumen loss and lower MLDPP (in device). Reference Brie D et al (2016) Int J Cardiol. 215, 47-59.

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