Polymer-Free Biolimus-Eluting Stents or Polymer-Based Zotarolimus-Eluting Stents for Coronary Bifurcation Lesions

Gallone, Guglielmo; D’Ascenzo, Fabrizio; Ielasi, Alfonso; Landra, Federico; Biasi, Maurizio Di; Mancone, Massimo; Tomai, Fabrizio; Infantino, Vincenzo; Rognoni, Andrea; Briguori, Carlo; Boccuzzi, Giacomo; Smołka, Grzegorz; Chiarito, Mauro; Capodanno, Davide; Chieffo, Alaide; Fabbiocchi, Franco; Poli, Arnaldo; Tespili, Maurizio; D’Urbano, Maurizio; Giordano, Arturo; Escaned, Javier; Ferrari, Gaetano Maria De; Sardella, Gennaro

doi:10.1016/j.carrev.2021.04.005

Cited by 3 publications

(4 citation statements)

References 24 publications

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Section: Reviewmentioning

confidence: 99%

“…In a cohort of patients receiving percutaneous coronary intervention for coronary bifurcation disease, Gallone et al [ 39 ] reported no significant difference in the risk of major adverse cardiac events (MACE) between the polymer-free-biolimus eluting stent (PF-BES) and the ZES stents at 400 days. Patients who were presented with stable coronary artery disease or non-left main (LM) bifurcation lesions had a trend towards higher rates of adverse events with the PF-BES, but these rates were not statistically significant [ 39 ]. In aspects of major adverse cardiovascular events, all-cause mortality, stent thrombosis, and target lesion revascularizations, the current analysis suggests that both PF-BES and ZES have an improved therapeutic profile when used for the cure of bifurcation lesions.…”

Section: Reviewmentioning

confidence: 99%

“… van Hemert et al (2021) [ 37 ] Multi-RCT PF-AES PP-ZES Clinical symptoms of ischemia indicating the presence of coronary artery stenosis requiring PCI - Rozemeijer et al (2019) [ 38 ] Prospective registry PF‐AES PP-ZES Stable coronary artery disease or acute coronary syndromes, and at least one coronary artery lesion with more than 50% diameter stenosis eligible for treatment with either PF‐AES or PP‐ZES implantation between January 2014 and February 2016 implantation of bare‐metal stents, a combination of DES, or revascularization prior to transcatheter aortic valve implantation. Gallone et al (2021) [ 39 ] Multicenter observational PF-BES PP-ZES Chronic coronary artery disease or acute coronary syndromes. Patients with a target lesion in the left main artery, multiple stent types, or an allergy to study medication, patients more likely to require multiple stents.…”

Section: Tablementioning

confidence: 99%

“…FIGURE 10: Forest plot showing target lesion revascularization (TLR).RR: relative risk, CI: confidence interval, PF-DES: polymer-free drug-eluting stent, PC-DES: polymer-coated drug-eluting stent.Sources: References[19][20][21][22][23][24][25][26][27][28][29][30][31]33,[35][36][37][38][39][40][41].…”

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confidence: 99%

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Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

Khatri¹,

Kumar²,

Mahfooz³

et al. 2023

Cureus

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Drug-eluting stents have transformed the treatment of coronary artery disease (CAD), and there are two types: polymer-free and polymer-coated stents. Polymer-free stents have a coating that is quickly absorbed by the body, whereas polymer-coated stents have a coating that remains on the stent surface. This meta-analysis and systematic review aimed to compare the clinical outcomes of these two stent types in patients with coronary artery disease. The literature and abstracts from significant databases were reviewed to compare polymer-free drug-eluting stents (PF-DES) and polymer-coated drug-eluting stents (PC-DES) for the treatment of coronary artery disease (CAD). The primary efficacy endpoints of the study were all-cause mortality and deaths from cardiovascular and non-cardiovascular causes. Among the secondary outcomes were incidences of myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), stent thrombosis, stroke, and major adverse cardiovascular events (MACEs). In terms of the primary outcomes, the combined analysis revealed a marginally lower risk of all-cause mortality (relative risk, RR (95% CI) = 0.92 (0.85, 1.00), p = 0.05, I 2 = 0%) with the use of PF-DES versus PC-DES. Nonetheless, there was no significant difference in cardiovascular mortality (RR (95% CI) = 0.97 (0.87, 1.08)) or non-cardiovascular mortality (RR (95% CI) = 0.87 (0.69, 1.10), p = 0.25, I 2 = 9%) between the groups. Furthermore, univariate meta-regression revealed that male gender and prior myocardial infarction were independently associated with an increased risk of all-cause mortality and cardiovascular disease. According to the current meta-analysis, no statistically significant differences existed in PF-DES and PC-DES outcomes. More extensive research is needed to investigate these findings further and establish their validity.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

mentioning

confidence: 99%

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Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

Khatri¹,

Kumar²,

Mahfooz³

et al. 2023

Cureus

View full text Add to dashboard Cite

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The Emperor's New Clothes: Dispelling the Myth of Improved Safety With Bare Metal

Fischell

2022

Cardiovascular Revascularization Medicine

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Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors

Mohamad,

Jyotsna,

Farooq

et al. 2023

Cureus

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The field of cardiovascular medicine is undergoing a transformative shift towards personalized medicinal therapy, particularly in the context of post stent implantation. This narrative review explores the significance, challenges, and future directions of individualized treatment strategies for patients with coronary stents. The review highlights the pivotal role of personalized approaches in optimizing treatment efficacy and minimizing adverse events. Real-world clinical studies and trials underscore the importance of tailoring antiplatelet therapy based on platelet function testing, genetic testing, and risk scoring. These studies reveal that personalized medicinal treatment improves clinical outcomes by balancing preventing thrombotic events and mitigating bleeding risks. Challenges, including cost, test availability, patient adherence, and ethical considerations, are discussed in depth, shedding light on the complexities of implementing personalized approaches. Technological advancements, including omics data integration, artificial intelligence, and big data analytics, shape the future of personalized medicinal therapy. These tools enable precise pharmacogenomic selection of medications and the development of integrated risk-scoring systems. Patient engagement and education are also central, with empowered patients and remote monitoring contributing to collaborative decision-making. In conclusion, the narrative review underscores that personalized medicinal therapy post stent implantation holds immense promise for revolutionizing cardiovascular care. By embracing a comprehensive approach that considers genetics, clinical factors, and patient preferences, healthcare providers can optimize treatment outcomes and improve patient quality of life. The evolving landscape of personalized medicine offers a glimpse into a future where tailored treatment strategies become the cornerstone of precision cardiovascular care.

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Polymer-Free Biolimus-Eluting Stents or Polymer-Based Zotarolimus-Eluting Stents for Coronary Bifurcation Lesions

Cited by 3 publications

References 24 publications

Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

Clinical Outcomes of Polymer-Free Versus Polymer-Coated Drug-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

The Emperor's New Clothes: Dispelling the Myth of Improved Safety With Bare Metal

Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors

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