BP-BES better than DP-DES at reducing adverse events, stent thrombosis
BP-BES (biodegradable polymer biolimus-eluting stents) leads to lower rates of target lesion revascularization (TLR), major adverse cardiac events (MACE) and stent thrombosis (ST) at 5 years compared with DP-DES (durable polymer drug-eluting stents), according to a new meta-analysis.
After applying the selection criteria, the meta-analysis was performed on five studies corresponding to 4,687 patients. The studies were retrieved from the databases of the Cochrane Library, Embase and PubMed.
Pooled data from four trials showed that BP-BES significantly reduced the risk of MACE compared to first-generation DP-DES (odds ratio [OR], 0.80; 95 percent CI, 0.68 to 0.95; p=0.01). In contrast, the risk of MACE was not significantly different between BP-BES and second-generation DP-DES (OR, 0.96; 0.68 to 1.37p =0.38).
Overall, however, BP-BES significantly reduced the risk of MACE compared with DP-DES (OR, 0.83; 0.71 to 0.97; p=0.02). Similarly, BP-BES significantly reduced the risk of TLR compared to first-generation (OR, 0.73; 0.58 to 0.92; p=0.008) but not second-generation (OR, 1.34; 0.63 to 2.83; p=0.44) DP-DES. Overall, BP-BES was better than DP-DES in reducing the risk of TLR (OR, 0.77; 0.62 to 0.96; p=0.02).
BP-BES was again superior to first-generation (OR, 0.57; 0.39 to 0.82; p=0.002) but not second-generation (OR, 87; 0.35 to 2.16; p=0.76) DP-DES in reducing the risk of ST. Overall, the risk of ST was significantly lower with BP-BES than DP-DES (OR, 0.60; 0.43 to 0.84; p=0.003).
On the other hand, BP-BES showed no clear advantage over DP-DES in reducing the risk of death (OR, 0.89; 0.72 to 1.11; p=0.30), myocardial infarctions (OR, 0.88; 0.70 to 1.10; p=0.27) and target vessel revascularization (OR, 0.89; 0.73 to 1.08; p=0.23).