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
Book Volume: 19
Pages Range: 1294-1301
Journal Issue: 11
DOI: 10.1093/ehjci/jex334
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.
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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