Comparison of clinical outcomes between bioresorbable vascular stents versus conventional drug-eluting and metallic stents: A systematic review and meta-analysis

MacIej Banach, Maria Corina Serban, Amirhossein Sahebkar, Hector M. García-García, Dimitri P. Mikhailidis, Seth S. Martin, Daniel Brie, Jacek Rysz, Peter P. Toth, Steven R. Jones, Rani K. Hasan, Svetlana Mosteoru, Mahmoud Al Rifai, Michael J. Pencina, Patrick W. Serruys

Research output: Contribution to journalReview articlepeer-review

Abstract

Aims: Several studies have suggested good procedural and similar clinical outcomes between everolimus-eluting Absorb bioresorbable stents (BRS) versus conventional drug-eluting stents (DES), but the evidence is not definitive. Our aim was to perform a systematic review and meta-analysis to investigate the effects of BRS versus conventional drug-eluting and bare metallic stents on the cardiovascular endpoints and all-cause mortality. Methods and results: The follow-up in the included studies was up to 13 months. The following endpoints were evaluated: all-cause mortality, cardiac death, patient-oriented major adverse cardiac events (POCE), device-oriented major adverse cardiac events (DOCE), any-cause myocardial infarction (MI), target vessel MI (TVMI), target vessel revascularisation (TVR) and target lesion revascularisation (TLR). The results of 10 studies with 5,773 subjects showed a statistically significant increase in the risk of TVMI between BRS and conventional stents (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.03-2.05, p=0.032). None of the other differences reached statistical significance: all-cause mortality (OR: 0.67, 95% CI: 0.30-1.49, p=0.333), cardiac death (OR: 1.00, 95% CI: 0.47-2.12, p=0.996), POCE (OR: 0.91, 95% CI: 0.68-1.22, p=0.546), DOCE (OR: 1.12, 95% CI: 0.86-1.46, p=0.387), any-cause MI (OR: 1.34, 95% CI: 0.98-1.82, p=0.064), TVR (OR: 0.99, 95% CI: 0.73-1.33, p=0.934) and TLR (OR: 0.92, 95% CI: 0.66-1.29, p=0.641). Similar results were observed after restricting the meta-analysis to the comparison of BRS vs. EES. Conclusions: Our meta-analysis suggests a significantly higher risk of TVMI with BRS compared with conventional stents and no significant differences in the rates of occurrence of the other outcomes during one-year follow-up. Further studies with larger samples sizes, longer follow-up, different clinical scenarios and more complex lesions are required to confirm or refute our findings.

Original languageEnglish (US)
Pages (from-to)e175-e189
JournalEuroIntervention
Volume12
Issue number2
StatePublished - Jun 2016

Keywords

  • Absorb BRS
  • Bioresorbable vascular stents
  • Drug-eluting stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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