One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis
Abstract Background Diabetes mellitus (DM) and cardiovascular diseases often co-exist. Today, percutaneous coronary intervention (PCI) is the preferred revascularization procedure for majority of patients with coronary artery disease. Polymer-free amphilimus-eluting stents (AES) represent a novel el...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01673-8 |
| _version_ | 1828731773178085376 |
|---|---|
| author | Hong Wang Xiaoya Xie Quannan Zu Ming Lu Rongfa Chen Zhiren Yang Yongqiang Gao |
| author_facet | Hong Wang Xiaoya Xie Quannan Zu Ming Lu Rongfa Chen Zhiren Yang Yongqiang Gao |
| author_sort | Hong Wang |
| collection | DOAJ |
| description | Abstract Background Diabetes mellitus (DM) and cardiovascular diseases often co-exist. Today, percutaneous coronary intervention (PCI) is the preferred revascularization procedure for majority of patients with coronary artery disease. Polymer-free amphilimus-eluting stents (AES) represent a novel elution technology in the current era of drug-eluting stents. In this analysis, we aimed to systematically compare the cardiovascular outcomes which are associated with polymer-free amphilimus-eluting stents (AES) versus the durable polymer zotarolimus-eluting stents (ZES) for the treatment of patients with DM. Methods Http://www.ClinicalTrials.gov, EMBASE, Web of Science, MEDLINE, Cochrane database and Google Scholar were searched for publications comparing polymer-free AES versus durable polymer ZES in patients with DM. Selective cardiovascular outcomes were assessed. Statistical analysis was carried out by the latest version of the RevMan software. Risk ratio (RR) with 95% confidence interval (CI) was used to represent the data analysis. Results Four studies with a total number of 1795 participants with DM whereby 912 patients were assigned to be revascularized by the polymer-free AES and 883 patients were assigned to be revascularized by the durable polymer ZES were included in this analysis. In patients with DM, at one year, polymer-free AES were associated with significantly lower risk of major adverse cardiac events (MACEs) (RR: 0.69, 95% CI: 0.54–0.88; P = 0.002) and target lesion failure (TLF) (RR: 0.66, 95% CI: 0.48–0.91; P = 0.01) compared to durable polymer ZES. However, there was no significant change in all-cause mortality (RR: 0.79, 95% CI: 0.51–1.22; P = 0.28), cardiac death and the other cardiovascular outcomes. Similar risk of total stent thrombosis (RR: 1.13, 95% CI: 0.60–2.13; P = 0.70), including definite stent thrombosis (RR: 1.12, 95% CI: 0.38–3.31; P = 0.84), probable stent thrombosis (RR: 0.87, 95% CI: 0.37–2.09; P = 0.76), possible stent thrombosis (RR: 1.19, 95% CI: 0.50–2.87; P = 0.69) and late stent thrombosis (RR: 1.00, 95% CI: 0.17–5.72; P = 1.00) as between polymer-free AES and durable polymer ZES in patients with DM. Conclusions At 1 year follow-up, polymer-free AES were associated with significantly lower MACEs and TLF compared to durable polymer ZES in these patients with DM, without any increase in mortality, stent thrombosis and other cardiovascular outcomes. However, this analysis is only based on a follow-up time period of one year, therefore, future research should focus on the long term follow-up time period. |
| first_indexed | 2024-04-12T17:51:14Z |
| format | Article |
| id | doaj.art-b82308285c904ae4bcd8c70e9c6e1b0d |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-12T17:51:14Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-b82308285c904ae4bcd8c70e9c6e1b0d2022-12-22T03:22:30ZengBMCCardiovascular Diabetology1475-28402022-10-0121111010.1186/s12933-022-01673-8One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysisHong Wang0Xiaoya Xie1Quannan Zu2Ming Lu3Rongfa Chen4Zhiren Yang5Yongqiang Gao6Department of Cardiology, The People’s Hospital of Guangxi Zhuang Autonomous RegionMacau University of Science and TechnologyCollege of Management and Economics, Tianjin UniversityCollege of Management and Economics, Tianjin UniversityThe State Key Laboratory Management and Control for Complex Systems, Institute of Automation, Chinese Academy of SciencesThe State Key Laboratory Management and Control for Complex Systems, Institute of Automation, Chinese Academy of SciencesDepartment of Cardiology, The People’s Hospital of Guangxi Zhuang Autonomous RegionAbstract Background Diabetes mellitus (DM) and cardiovascular diseases often co-exist. Today, percutaneous coronary intervention (PCI) is the preferred revascularization procedure for majority of patients with coronary artery disease. Polymer-free amphilimus-eluting stents (AES) represent a novel elution technology in the current era of drug-eluting stents. In this analysis, we aimed to systematically compare the cardiovascular outcomes which are associated with polymer-free amphilimus-eluting stents (AES) versus the durable polymer zotarolimus-eluting stents (ZES) for the treatment of patients with DM. Methods Http://www.ClinicalTrials.gov, EMBASE, Web of Science, MEDLINE, Cochrane database and Google Scholar were searched for publications comparing polymer-free AES versus durable polymer ZES in patients with DM. Selective cardiovascular outcomes were assessed. Statistical analysis was carried out by the latest version of the RevMan software. Risk ratio (RR) with 95% confidence interval (CI) was used to represent the data analysis. Results Four studies with a total number of 1795 participants with DM whereby 912 patients were assigned to be revascularized by the polymer-free AES and 883 patients were assigned to be revascularized by the durable polymer ZES were included in this analysis. In patients with DM, at one year, polymer-free AES were associated with significantly lower risk of major adverse cardiac events (MACEs) (RR: 0.69, 95% CI: 0.54–0.88; P = 0.002) and target lesion failure (TLF) (RR: 0.66, 95% CI: 0.48–0.91; P = 0.01) compared to durable polymer ZES. However, there was no significant change in all-cause mortality (RR: 0.79, 95% CI: 0.51–1.22; P = 0.28), cardiac death and the other cardiovascular outcomes. Similar risk of total stent thrombosis (RR: 1.13, 95% CI: 0.60–2.13; P = 0.70), including definite stent thrombosis (RR: 1.12, 95% CI: 0.38–3.31; P = 0.84), probable stent thrombosis (RR: 0.87, 95% CI: 0.37–2.09; P = 0.76), possible stent thrombosis (RR: 1.19, 95% CI: 0.50–2.87; P = 0.69) and late stent thrombosis (RR: 1.00, 95% CI: 0.17–5.72; P = 1.00) as between polymer-free AES and durable polymer ZES in patients with DM. Conclusions At 1 year follow-up, polymer-free AES were associated with significantly lower MACEs and TLF compared to durable polymer ZES in these patients with DM, without any increase in mortality, stent thrombosis and other cardiovascular outcomes. However, this analysis is only based on a follow-up time period of one year, therefore, future research should focus on the long term follow-up time period.https://doi.org/10.1186/s12933-022-01673-8Diabetes mellitusPolymer-free Amphilimus-eluting stentsDurable polymer zotarolimus-eluting stentsPercutaneous coronary interventionCardiovascular outcomesTarget lesion failure |
| spellingShingle | Hong Wang Xiaoya Xie Quannan Zu Ming Lu Rongfa Chen Zhiren Yang Yongqiang Gao One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis Cardiovascular Diabetology Diabetes mellitus Polymer-free Amphilimus-eluting stents Durable polymer zotarolimus-eluting stents Percutaneous coronary intervention Cardiovascular outcomes Target lesion failure |
| title | One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis |
| title_full | One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis |
| title_fullStr | One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis |
| title_full_unstemmed | One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis |
| title_short | One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis |
| title_sort | one year outcomes of polymer free amphilimus eluting stents versus durable polymer zotarolimus eluting stents in patients with diabetes mellitus a meta analysis |
| topic | Diabetes mellitus Polymer-free Amphilimus-eluting stents Durable polymer zotarolimus-eluting stents Percutaneous coronary intervention Cardiovascular outcomes Target lesion failure |
| url | https://doi.org/10.1186/s12933-022-01673-8 |
| work_keys_str_mv | AT hongwang oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT xiaoyaxie oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT quannanzu oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT minglu oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT rongfachen oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT zhirenyang oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis AT yongqianggao oneyearoutcomesofpolymerfreeamphilimuselutingstentsversusdurablepolymerzotarolimuselutingstentsinpatientswithdiabetesmellitusametaanalysis |