Author + information
- Brian Forrestal,
- Micaela Iantorno,
- Rebecca Torguson,
- Michael J. Lipinski and
- Ron Waksman
We performed a network meta-analysis of randomized controlled trials (RCTs) to assess the impact of biodegradable polymer stent strut thickness on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI).
We searched MEDLINE/PubMed and performed a Bayesian network meta-analysis to compare outcomes of patients undergoing PCI with thin strut biodegradable polymer stents (<90 μm), thick strut biodegradable polymer stents (>90 μm), first-generation drug eluting stents (DES) and second-generation DES. Fully biodegradable scaffolds were excluded. Odds ratios with credible intervals (OR [CrIs]) were generated with random-effects models to compare outcomes.
We identified 30 RCTs with a total of 35,067 patients. Mean age was 65 ± 11 years and 76% were male. When compared with second generation DES, thin strut biodegradable polymer stents were associated with a significant reduction in stent thrombosis (OR 0.69 [CrI 0.5-0.97]). However, thick strut biodegradable polymer stents were not associated with a reduction in stent thrombosis compared with second generation DES (OR 1.03 [CrI 0.73-1.58], Figure 1). When compared to second generation DES, major adverse cardiac events (MACE), myocardial infarction, target lesion revascularization, all- cause mortality, and cardiovascular death (CV death) were not significantly reduced for either the thin strut or thick strut groups.
Thin strut biodegradable polymer stents (<90 μm) were associated with a significant reduction in the rate of definite or probable stent thrombosis compared to second-generation DES.