Vascular response to percutaneous coronary intervention with biodegradable-polymer vs. new-generation durable-polymer drug-eluting stents: A meta-analysis of optical coherence tomography imaging trials
Cassese S, Xhepa E, Ndrepepa G, Kufner S, Colleran R, Giacoppo D, Koppara T, Mankerious N, Byrne RA, Laugwitz KL, Schunkert H, Fusaro M, Kastrati A, Joner M (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 19
Pages Range: 1294-1301
Journal Issue: 11
DOI: 10.1093/ehjci/jex334
Abstract
Aims Whether biodegradable-polymer drug-eluting stents (BP-DES) induce a vascular response at follow-up more favourable than that of new-generation durable-polymer drug-eluting stents (DP-DES) remains controversial. We sought to evaluate the vascular response to percutaneous coronary intervention (PCI) with BP-DES vs. new-generation DP-DES as assessed by optical coherence tomography (OCT) imaging at follow-up. Methods and results We undertook a meta-analysis of aggregate data by searching electronic scientific databases for investigations of PCI-patients receiving BP-DES vs. new-generation DP-DES and OCT imaging at follow-up. The primary outcome was neointima hyperplasia (NIH) thickness. The co-primary outcome was the incidence of lesions with uncovered struts. The main secondary outcome was the incidence of lesions with malapposed struts. Among 10 trials, a total of 544 PCI-patients were assigned to BP-DES (n = 282) or new-generation DP-DES (n = 262). Of these, 447 participants with 480 treated lesions had analysable OCT imaging at a weighted median follow-up of 7 months. Lesions treated with BP-DES vs. new-generation DP-DES showed comparable NIH thickness [weighted mean difference 95% confidence intervals (CI)= 11.37 (29.25, 6.52); P = 0.21]. However, thick-struts (>100 μm) BP-DES showed less NIH thickness as compared to new-generation DP-DES [20.39 (33.83, 6.95); P = 0.003]. BP-DES vs. new-generation DP-DES showed a higher risk for uncovered struts [odds ratio 95% CI = 3.50 (1.69-7.26); P = 0.0008] and a trend towards higher risk for malapposed struts [2.01 (0.98-4.12); P = 0.06]. Conclusion In PCI-patients with available OCT imaging at follow-up, BP-DES with thicker backbones delay vascular response as compared with new-generation DP-DES. All rights reserved.
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Germany (DE)How to cite
APA:
Cassese, S., Xhepa, E., Ndrepepa, G., Kufner, S., Colleran, R., Giacoppo, D.,... Joner, M. (2018). Vascular response to percutaneous coronary intervention with biodegradable-polymer vs. new-generation durable-polymer drug-eluting stents: A meta-analysis of optical coherence tomography imaging trials. European Heart Journal - Cardiovascular Imaging, 19(11), 1294-1301. https://doi.org/10.1093/ehjci/jex334
MLA:
Cassese, Salvatore, et al. "Vascular response to percutaneous coronary intervention with biodegradable-polymer vs. new-generation durable-polymer drug-eluting stents: A meta-analysis of optical coherence tomography imaging trials." European Heart Journal - Cardiovascular Imaging 19.11 (2018): 1294-1301.
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