Clinical outcomes with bioabsorbable polymer- versus durable polymer-based drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis

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#cardiovascular-agents #chromium-alloys #coated-materials-biocompatible #coronary-thrombosis #drug-eluting-stents

Clinical outcomes with bioabsorbable polymer- versus durable polymer-based drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis

Palmerini et al., 2014 | J Am Coll Cardiol | Narrative Review

Citation

Palmerini Tullio, Biondi-Zoccai Giuseppe, ... Stone Gregg W. Clinical outcomes with bioabsorbable polymer- versus durable polymer-based drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. J Am Coll Cardiol. 2014-Feb-04;63(4):299-307. doi:10.1016/j.jacc.2013.09.061

Abstract

OBJECTIVES: This study sought to investigate the relative safety and efficacy of bioabsorbable polymer (BP)-based biolimus-eluting stents (BES) versus durable-polymer (DP)-drug-eluting stents (DES) and bare-metal stents (BMS) by means of a network meta-analysis. BACKGROUND: Studies have suggested that BP-BES might reduce the risk of stent thrombosis (ST) and late adverse outcomes compared with first-generation DES. However, the relative safety and efficacy of BP-BES versus newer-generation DES coated with more biocompatible DP have not been investigated in depth. METHODS: Randomized controlled trials comparing BP-BES versus currently U.S.-approved DES or BMS were searched through MEDLINE, EMBASE, and Cochrane databases. Information on study design, inclusion and exclusion criteria, sample characteristics, and clinical outcomes was extracted. RESULTS: Data from 89 trials including 85,490 patients were analyzed. At 1-year follow-up, BP-BES were associated with lower rates of cardiac death/myocardial infarction (MI), MI, and target vessel revascularization (TVR) than BMS and lower rates of TVR than fast-release zotarolimus-eluting stents. The BP-BES had similar rates of cardiac death/MI, MI, and TVR compared with other second-generation DP-DES but higher rates of 1-year ST than cobalt-chromium everolimus-eluting stents (CoCr-EES). The BP-BES were associated with improved late outcomes compared with BMS and paclitaxel-eluting stents, considering the latest follow-up data available, with nonsignificantly different outcomes compared with other DP-DES although higher rates of definite ST compared with CoCr-EES. CONCLUSIONS: In this large-scale network meta-analysis, BP-BES were associated with superior clinical outcomes compared with BMS and first-generation DES and similar rates of cardiac death/MI, MI, and TVR compared with second-generation DP-DES but higher rates of definite ST than CoCr-EES.

Key Findings

Data from 89 trials including 85,490 patients were analyzed. At 1-year follow-up, BP-BES were associated with lower rates of cardiac death/myocardial infarction (MI), MI, and target vessel revascularization (TVR) than BMS and lower rates of TVR than fast-release zotarolimus-eluting stents. The BP-BES had similar rates of cardiac death/MI, MI, and TVR compared with other second-generation DP-DES but higher rates of 1-year ST than cobalt-chromium everolimus-eluting stents (CoCr-EES). The BP-BES we

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 85490
Age Range See abstract
Condition See abstract

MeSH Terms

  • Cardiovascular Agents
  • Chromium Alloys
  • Coated Materials, Biocompatible
  • Coronary Thrombosis
  • Drug-Eluting Stents
  • Everolimus
  • Humans
  • Myocardial Infarction
  • Myocardial Revascularization
  • Paclitaxel
  • Polymers
  • Randomized Controlled Trials as Topic
  • Sirolimus
  • Stents

Evidence Classification

  • Level: Narrative Review
  • Publication Types: Journal Article, Review, Network Meta-Analysis
  • Vertical: chromium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09