Meta-Analysis of Randomized Clinical Trials Comparing Biodegradable Polymer Drug-Eluting Stent to Second-Generation Durable Polymer Drug-Eluting Stents

El-Hayek, Georges; Bangalore, Sripal; Dominguez, Abel Casso; Devireddy, Chandan; Jaber, Wissam; Kumar, Gautam; Mavromatis, Kreton; Tamis-Holland, Jacqueline; Samady, Habib

doi:10.1016/j.jcin.2016.12.002

Cited by 143 publications

(101 citation statements)

References 37 publications

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“…Further evidence to suggest that these technologies may not be beneficial can be drawn from a 19 886 patient meta‐analysis of RCTs comparing clinical outcomes between biodegradeable‐polymer DES against PP‐DES. Again, the authors found no significant difference in outcomes between devices at longest follow‐up and on landmark analysis beyond 1‐year . Taken together, these results suggest that it will be for clinicians to decide on whether these newer DES platforms will become the workhorse platforms of the future.…”

Section: Discussionmentioning

confidence: 94%

Polymer‐free versus permanent polymer‐coated drug eluting stents for the treatment of coronary artery disease: A meta‐analysis of randomized trials

Nogic

Baey

Nerlekar

et al. 2018

J Interven Cardiology

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Section: Discussionmentioning

confidence: 94%

Polymer‐free versus permanent polymer‐coated drug eluting stents for the treatment of coronary artery disease: A meta‐analysis of randomized trials

Nogic

Baey

Nerlekar

et al. 2018

J Interven Cardiology

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“…As the first randomized trial to show improvement over Xience DES in a complex population (50.8% ACS, 35% DM), it suggests continued improvement in DES technology. Otherwise, a large meta‐analysis of 16 randomized trials including 19 886 patients demonstrated similar TVR, MI, ST of both biodegradable polymer DES and second‐generation drug polymer DES with similar outcome at a mean follow up of 26 months regardless of eluting drug or stent platform . With previous RCT data showing BP‐DES superiority over 1st generation DES, this analysis suggests similar efficacy and safety of both stent platforms when 2nd generation DES is used as the control.…”

Section: Choice Of Stentmentioning

confidence: 56%

Percutaneous coronary intervention: 2017 in review

Rao

Sheth

Grines

2018

J Interven Cardiology

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In an effort to keep the interventional community up-to-date with the abundant amount of new data, we have selected what we believe to be the most important publications in percutaneous coronary intervention from January 1, 2017 to 2 The overall rate of complete revascularization (CR) was 61.7%.In those patients with CR, there was no difference between CABG or PCI regarding death from any cause as well as composite of death, MI, and stroke at 5 year follow up, even at higher SYNTAX scores.However, compared to CABG with CR, PCI with incomplete revascularization put patients at a significant higher risk for similar endpoints. These studies suggest that the ability to achieve CR should be strongly considered when deciding between CABG and PCI in MVD.As we have learned from contemporary data on revascularization, certain subsets of patients have fared better with one revascularization strategy over another. An observational cohort study of multiple Swedish registries found that in patients with Type 1 diabetes and MVD, first multi-vessel revascularization with PCI was associated with higher risk of cardiac death, MI, and repeat revascularization although with similar all-cause mortality when compared to CABG. 3 This study indicates that CABG may be the preferred strategy in patients with Type 1 diabetes in need of multi-vessel revascularization, and is in agreement with earlier trials showing most of the benefit in patients treated with insulin, but not oral agents.In patients with low or intermediate SYNTAX score, PCI of unprotected left main with everolimus-eluting stents (EES) was shown to be noninferior to CABG with respect to a composite endpoint of death, stroke, and MI at 3 years in the EXCEL trial. 4 Of the 1905 patients randomized during the trial, 1788 patients were also followed for quality of life assessment to fully understand patient's perspective.

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“…Sirolimus BP‐DES shares the same efficacy and safety as the most widely used second‐generation DP‐DES . The 3‐year TLF risk of EXCROSSAL was similar to CoCr‐EES (7.1%) in the PLATIUM study, and also carried a similar risk of definite and probable ST (0.5%) .…”

Section: Discussionmentioning

confidence: 80%

“…Sirolimus BP-DES shares the same efficacy and safety as the most widely used second-generation DP-DES. [11][12][13][14] The 3-year TLF risk of EXCROSSAL was similar to CoCr-EES (7.1%) in the PLATIUM study, and also carried a similar risk of definite and probable ST (0.5%). 15 For East Asian patients, the 3-year TLF of CoCr-EES in the ABSORB China study was 4.7%, slightly lower than this study, which may be related to shorter lesions and greater RVD.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Three‐year follow up of biodegradable polymer cobalt‐chromium sirolimus‐eluting stent (EXCROSSAL) in treating de novo coronary artery disease: Pooled analysis of CREDIT II and CREDIT III trials

Wang

Tao

et al. 2020

Cathet Cardio Intervent

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Objectives To analyze the 3‐year outcomes of the biodegradable polymer cobalt‐chromium sirolimus‐eluting stent (EXCROSSAL) in CREDIT II AND III TRIALS. Background Though approved by CFDA, the long‐term safety and efficacy of EXCROSSAL is still unknown. Methods CREDIT II was a randomized trial comparing the EXCROSSAL versus EXCEL stents in patients with up to two de novo coronary lesions, and CREDIT III was a prospective, single‐arm study evaluating the efficacy and safety of EXCROSSAL in broad types of de novo coronary artery lesions. We pooled the 3‐year follow‐up data of the EXCROSSAL arm of the CREDIT II and CREDIT III Trials. The primary outcome was 3‐year target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction (TV‐MI), and clinically indicated target lesion revascularization (CI‐TLR). The patient‐oriented composite endpoint (PoCE) (all‐cause death, all MI, or any revascularization) and stent thrombosis (ST) were also analyzed. Results A total of 833 patients were included in this study. The incidence of TLF and PoCE in the 3‐year follow‐up were 7.6% and 12.5%, respectively. ST occurred in 0.6% of patients. In the subgroup analyses, TLF was significantly higher in small target vessels, multi‐lesion PCI, and multi‐vessel disease. Conclusions The 3‐year follow‐up analysis confirmed low rates of TLF and ST in EXCROSSAL, which is similar to the most widely used new generation durable polymer drug‐eluting stent.

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Meta-Analysis of Randomized Clinical Trials Comparing Biodegradable Polymer Drug-Eluting Stent to Second-Generation Durable Polymer Drug-Eluting Stents

Cited by 143 publications

References 37 publications

Polymer‐free versus permanent polymer‐coated drug eluting stents for the treatment of coronary artery disease: A meta‐analysis of randomized trials

Polymer‐free versus permanent polymer‐coated drug eluting stents for the treatment of coronary artery disease: A meta‐analysis of randomized trials

Percutaneous coronary intervention: 2017 in review

Three‐year follow up of biodegradable polymer cobalt‐chromium sirolimus‐eluting stent (EXCROSSAL) in treating de novo coronary artery disease: Pooled analysis of CREDIT II and CREDIT III trials

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