Document Type
Article
Publication Date
2-18-2025
Abstract
BACKGROUND: The utility of polymer-permanent, polymer-absorbable, and polymer-free drug-eluting stents (DES) in the context of different eluting drugs in patients undergoing percutaneous coronary intervention (PCI) remains controversial.
OBJECTIVES: The purpose of this study was to compare the efficacy of different DES strategies in post-PCI patients.
METHODS: Digital databases were searched to select all randomized control trials. Different combinations of DES were directly compared with permanent-polymer sirolimus-eluting stents. The primary outcome was major adverse cardiovascular events; a composite of cardiovascular mortality, myocardial infarction (MI), and target vessel revascularization. A network meta-analysis was performed to determine the net relative risk (RR) and its 95% CI.
RESULTS: A total of 314 randomized control trials comprising 345,749 patients with coronary artery disease undergoing PCI were included. Compared with polymer-permanent sirolimus-eluting stent, polymer-free titanium-nitride-oxide (RR: 0.68; 95% CI: 0.53-0.87), polymer-permanent everolimus (RR: 0.89; 95% CI: 0.82-0.96), and zotarolimus stents (RR: 0.89; 95% CI: 0.79-0.99) had a lower risk of major adverse cardiovascular events at 5 years. Polymer-free titanium-nitride-oxide stents also had a significantly lower incidence of stent thrombosis (RR: 0.28; 95% CI: 0.13-0.59) and MI (RR: 0.41; 95% CI: 0.27-0.62) at 1 year. Bare metal stents had a significantly higher 1-year risk of MI (RR: 1.52; 95% CI: 1.25-1.86), and need for target vessel revascularization (RR: 2.26; 95% CI: 1.93-2.64).
CONCLUSIONS: In comparison with polymer-permanent sirolimus, the newer stents including polymer-free titanium-nitride-oxide, polymer-permanent everolimus, and zotarolimus stents significantly reduce the risk of long-term ischemic events.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Ullah, Waqas; Sandhyavenu, Harigopal; Zaidi, Syeda Ramsha; Alonso, Mileydis; Khan, Muhammad Atif; Ullah, Irfan; Yasmin, Farah; Polam, Aravind Reddy; Zahid, Salman; Kumar, Arnav; Steyerberg, Ewout; Murtaza, Mohammed; Alraiesm, Chadi; and Rade, Jeffrey, "Safety and Efficacy of Different Stent Strategies in Percutaneous Coronary Intervention: A Network Meta-Analysis" (2025). Jefferson Health - Northeast Papers (formerly Aria Health Papers). Paper 5.
https://jdc.jefferson.edu/ariafp/5
Language
English
PubMed ID
39970740
Comments
This article is the author's final published version in JACC: Advances, Volume 4, Issue 3, 2025, Article number 101600.
The published version is available at https://doi.org/10.1016/j.jacadv.2025.101600.
Copyright © 2025 The Authors