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Title: | Polymer-free versus permanent polymer-coated drug eluting stents for the treatment of coronary artery disease: A meta-analysis of randomized trials. | Authors: | Nogic J.;Baey Y.-W.;Nerlekar N. ;Ha F.J.;Cameron J.D.;Nasis A. ;West N.E.J.;Brown A.J. | Institution: | (Nogic, Baey, Nerlekar, Ha, Cameron, Nasis, Brown) Monash Cardiovascular Research Centre, Monash University and Monash Heart, Monash Health, Melbourne, VIC, Australia (West) Department of Interventional Cardiology, Papworth Hospital NHS Trust, Cambridge, United Kingdom | Issue Date: | 2-Oct-2018 | Copyright year: | 2018 | Publisher: | Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com) | Place of publication: | United States | Publication information: | Journal of Interventional Cardiology. 31 (5) (pp 608-616), 2018. Date of Publication: October 2018. | Journal: | Journal of Interventional Cardiology | Abstract: | Background: Polymer-free drug eluting stents (PF-DES) were developed, in part, to overcome risk of late ischemic events observed with permanent polymer-coated DES (PP-DES). However, trial results are inconsistent with longer-term safety and efficacy of PF-DES remaining unknown. We performed a meta-analysis of randomized trials assessing outcomes of patients receiving PF-DES versus PP-DES for treatment of coronary artery disease (CAD). Method(s): Electronic searches were performed for randomized trials comparing outcomes between PF-DES and PP-DES. Trials reporting major adverse cardiovascular events (MACE), myocardial infarction (MI), stent thrombosis (ST), all-cause death, target lesion/vessel revascularization (TLR/TVR), and late lumen loss (LLL) were included. Analyses were performed at longest follow-up and landmarked beyond 1-year. Result(s): Twelve trials (6,943 patients) were included. There was no significant difference in MACE between PF-DES and PP-DES at longest follow-up (Odds Ratio [OR] 0.96, 95%CI 0.85-1.10, P = 0.59) or landmark analysis beyond 1-year (OR 0.96, 95%CI 0.76-1.20, P = 0.70). Although PF-DES were associated with a significant reduction in all-cause death (OR 0.85, 95%CI 0.72-1.00, P < 0.05), this effect was not present on landmark analysis beyond 1-year (OR 0.89, 95%CI 0.73-1.10, P = 0.30). There were no differences observed for MI (OR 1.00, 95%CI 0.77-1.28, P = 0.99) or ST (OR 0.95, 95%CI 0.54-1.68, P = 0.86), with similar efficacy outcomes including TVR (OR 1.07, 95%CI 0.91-1.26, P = 0.42), TLR (OR 1.03, 95%CI 0.88-1.21, P = 0.68) and angiographic LLL (pooled mean difference 0.01 mm, 95%CI -0.08 to 0.11, P = 0.76). Conclusion(s): PF-DES are as safe and efficacious as PP-DES for the treatment of patients with CAD, but do not significantly reduce late ischemic complications.Copyright © 2018 Wiley Periodicals, Inc. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/joic.12522 | ORCID: | Nogic, Jason; ORCID: http://orcid.org/0000-0002-5024-0729 | Link to associated publication: | Click here for full text options | PubMed URL: | 29797804 [http://www.ncbi.nlm.nih.gov/pubmed/?term=29797804] | ISSN: | 0896-4327 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/37331 | Type: | Article | Subjects: | paclitaxel/dt [Drug Therapy] probucol/dt [Drug Therapy] rapamycin/dt [Drug Therapy] zotarolimus/dt [Drug Therapy] drug eluting coronary stent *drug eluting stent/am [Adverse Device Effect] *drug eluting stent/dc [Device Comparison] *drug eluting stent/ct [Clinical Trial] everolimus eluting coronary stent/am [Adverse Device Effect] everolimus eluting coronary stent/ct [Clinical Trial] paclitaxel eluting coronary stent/am [Adverse Device Effect] paclitaxel eluting coronary stent/ct [Clinical Trial] sirolimus eluting coronary stent/am [Adverse Device Effect] sirolimus eluting coronary stent/ct [Clinical Trial] zotarolimus eluting coronary stent/am [Adverse Device Effect] zotarolimus eluting coronary stent/ct [Clinical Trial] late lumen loss amphilimus Cypher endeavour Nano partner *polymer coated drug eluting stent/am [Adverse Device Effect] *polymer coated drug eluting stent/dc [Device Comparison] *polymer coated drug eluting stent/ct [Clinical Trial] *polymer free drug eluting stent/am [Adverse Device Effect] *polymer free drug eluting stent/dc [Device Comparison] *polymer free drug eluting stent/ct [Clinical Trial] Resolute YinYi Yukon yukon choice xience expedition all cause mortality article cardiovascular disease/co [Complication] cardiovascular parameters clinical effectiveness *coronary artery disease/dt [Drug Therapy] *coronary artery disease/th [Therapy] *coronary stenting device safety follow up heart infarction/co [Complication] human meta analysis outcome assessment priority journal randomized controlled trial (topic) stent thrombosis/co [Complication] target lesion revascularization target vessel revascularization everolimus/dt [Drug Therapy] randomized controlled trial (topic) stent thrombosis / complication target lesion revascularization target vessel revascularization cardiovascular parameters cardiovascular disease / complication meta analysis Article human all cause mortality heart infarction / complication follow up clinical effectiveness priority journal device safety *coronary stenting *coronary artery disease / *drug therapy / *therapy outcome assessment |
Type of Clinical Study or Trial: | Systematic review and/or meta-analysis |
Appears in Collections: | Articles |
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