PT  - JOURNAL ARTICLE
AU  - Mohammad Riashad Monjur
AU  - Christian F Said
AU  - Paul Bamford
AU  - Michael Parkinson
AU  - Richard Szirt
AU  - Thomas Ford
TI  - Ultrathin-strut biodegradable polymer versus durable polymer drug-eluting stents: a meta-analysis
AID  - 10.1136/openhrt-2020-001394
DP  - 2020 Oct 01
TA  - Open Heart
PG  - e001394
VI  - 7
IP  - 2
4099  - http://openheart.bmj.com/content/7/2/e001394.short
4100  - http://openheart.bmj.com/content/7/2/e001394.full
SO  - Open Heart2020 Oct 01; 7
AB  - Objectives Determine whether an ultrathin biodegradable polymer sirolimus-eluting stent (‘Orsiro’—BP-SES) has clinical benefits over second-generation durable polymer drug-eluting stents (DP-DES).Methods We conducted a prospective systematic review and meta-analysis of randomised clinical trials comparing Orsiro BP-SES against DP-DES (PROSPERO Registration: CRD42019147136). The primary outcome was target lesion failure (TLF): composite of cardiac death, target vessel myocardial infarction (TVMI) and clinically indicated target lesion revascularisation (TLR)) evaluated at the longest available follow-up.Results Nine trials randomised 11 302 patients to either Orsiro BP-SES or DP-DES. At mean weighted follow-up of 2.8 years, the primary outcome (TLF) occurred in 501 of 6089 (8.2%) participants with BP-SES compared with 495 of 5213 (9.5%) participants with DP-DES. This equates to an absolute risk reduction of 1.3% in TLF in favour of Orsiro BP-SES (OR 0.82; 95% CI 0.69 to 0.98; p=0.03). This was driven by a reduction in TVMI (OR 0.80; 95% CI 0.65 to 0.98; p=0.03). There were no significant differences in other clinical endpoints: cardiac death, TLR and stent thrombosis.Conclusion The Orsiro BP-SES shows promising clinical outcomes in patients undergoing percutaneous coronary intervention compared with contemporary second-generation DES at a short to medium term follow-up. More research is warranted to evaluate performance over a longer follow-up period and in different clinical and lesion subsets.