Full text

Turn on search term navigation

© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background/Objectives: Polymer-free drug-eluting stents (PF-DESs) aim to mitigate long-term adverse effects associated with polymer-based platforms. However, clinical comparisons with biodegradable polymer DESs (BP-DESs) remain limited. The objective of this review is to assess the efficacy and safety of PF-DESs versus thin-struts (<100 μm) BP-DESs in patients undergoing percutaneous coronary intervention (PCI). Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PF-DESs and BP-DESs in adults undergoing PCI. PubMed, Embase, and CENTRAL were searched up to 1 February 2025. A random-effects model was used to calculate pooled risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Outcomes included myocardial infarction (MI), all-cause and cardiac death, target lesion revascularization (TLR), stent thrombosis, and angiographic/OCT parameters. Subgroup and sensitivity analyses were conducted for outcomes with high heterogeneity (I2 > 50%). Results: Nine RCTs (n = 9597) were included. At 12 months, no significant differences were found between PF-DESs and BP-DESs for TLR (RR 1.51; 95% CI: 0.83–2.75), MI, or stent thrombosis. At 24 months, MI and all-cause death were similar between groups. A subgroup analysis showed lower cardiac death with the BioFreedom stent (RR 0.57; 95% CI: 0.35–0.90), not observed in non-BioFreedom devices. No significant differences were detected in angiographic or OCT outcomes, though heterogeneity was high. Conclusions: PF-DESs and BP-DESs demonstrated comparable clinical performance. The observed benefit in cardiac death with BioFreedom may reflect device-specific effects and merits further investigation.

Details

Title
Polymer-Free Versus Biodegradable Polymer Drug-Eluting Stents in Coronary Artery Disease: Updated Systematic Review and Meta-Analysis of Clinical, Angiographic, and OCT Outcomes
Author
Marchetta Marcello 1   VIAFID ORCID Logo  ; Sasso Stefano 2   VIAFID ORCID Logo  ; Paragliola Vincenzo 2   VIAFID ORCID Logo  ; Parato Andrea Giovanni 2   VIAFID ORCID Logo  ; De Angelis Diego 2   VIAFID ORCID Logo  ; Russo, Giulio 2   VIAFID ORCID Logo  ; Albano, Giovanni 2   VIAFID ORCID Logo  ; Benedetto, Daniela 2 ; Moretti Federico 2 ; Valenti, Francesco 2 ; Massaro Gianluca 2   VIAFID ORCID Logo  ; Chiricolo Gaetano 2   VIAFID ORCID Logo  ; Manfredi, Tesauro 2 ; Sangiorgi, Giuseppe Massimo 2   VIAFID ORCID Logo 

 Division of Cardiology, University of Rome “Tor Vergata”, 00133 Rome, Italy; [email protected] (S.S.); [email protected] (V.P.); [email protected] (A.G.P.); [email protected] (D.D.A.); [email protected] (G.R.); [email protected] (G.A.); [email protected] (D.B.); [email protected] (F.M.); [email protected] (F.V.); [email protected] (G.M.); [email protected] (G.C.); [email protected] (M.T.), Division of Cardiology, University of Messina, 98168 Messina, Italy 
 Division of Cardiology, University of Rome “Tor Vergata”, 00133 Rome, Italy; [email protected] (S.S.); [email protected] (V.P.); [email protected] (A.G.P.); [email protected] (D.D.A.); [email protected] (G.R.); [email protected] (G.A.); [email protected] (D.B.); [email protected] (F.M.); [email protected] (F.V.); [email protected] (G.M.); [email protected] (G.C.); [email protected] (M.T.) 
First page
1470
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
22279059
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3223878207
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.