Five-Year Outcomes of Biodegradable Polymer Drug-Eluting Stents Versus Second-Generation Durable Polymer Drug-Eluting Stents: a Meta-Analysis of Randomized Controlled Trials

Purpose We investigated the safety and efficacy of biodegradable polymer drug-eluting stents (BP-DES) versus second-generation durable polymer drug-eluting stents (DP-DES) in a follow-up period of 5 years. Methods A meta-analysis was performed using data from the PubMed, EMBASE, and Cochrane Library databases. The primary endpoint was target lesion failure (TLF), a composite endpoint of safety and efficacy, which included cardiac death, target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR). Secondary endpoints were all-cause death, MI, TLR, definite or probable stent thrombosis (ST), and definite or probable very late ST. In addition, we performed subgroup analyses based on patient and stent characteristics. Results Nine randomized controlled trials (RCTs) in 11,817 patients were included in the meta-analysis. Compared with second-generation DP-DES, BP-DES was not associated with increased risk of TLF (odds ratio (OR) 1.06, 95% confidence interval [CI] 0.94-1.20; p = 0.33), all-cause death (OR 1.04, [0.92-1.18], p = 0.49), myocardial infarction (OR 0.97, [0.83-1.13], p = 0.67), target lesion revascularization (OR 1.08, [0.94-1.23], p = 0.27), definite or probable stent thrombosis (OR 0.85, [0.66-1.11], p = 0.24), or definite or probable very late stent thrombosis (OR 0.86, [0.58-1.26],p = 0.43). Furthermore, the subgroup analyses did not reveal any statistically significant differences between the stent groups. Conclusion At 5 years of follow-up, the safety and efficacy of BP-DES are clinically comparable to those of second-generation DP-DES.