PMID- 33350767
OWN - NLM
STAT- MEDLINE
DCOM- 20210115
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 52
DP  - 2020 Dec 24
TI  - Cardiovascular outcomes associated with Ultrathin bioresorbable polymer sirolimus 
      eluting stents versus thin, durable polymer everolimus eluting stents following 
      percutaneous coronary intervention in patients with type 2 diabetes mellitus: A 
      meta-analysis of published studies.
PG  - e23810
LID - 10.1097/MD.0000000000023810 [doi]
LID - e23810
AB  - BACKGROUND: Percutaneous coronary intervention with the new generation drug 
      eluting stents (DES) is 1 among the revascularization procedures required to 
      treat patients with coronary artery disease (CAD). Since late stent thrombosis 
      and silent myocardial infarction are highly associated with type 2 diabetes 
      mellitus (T2DM), an analysis comparing the newer generation DES in this specific 
      subgroup of patients would be scientifically relevant.In this analysis, we aimed 
      to systematically compare the cardiovascular outcomes observed with the ultrathin 
      bioresorbable polymer sirolimus eluting stents (SES) versus thin, durable polymer 
      everolimus eluting stents (EES) following percutaneous coronary intervention in 
      patients with T2DM. METHODS: Through online databases, relevant studies comparing 
      ultrathin bioresorbable polymer SES versus the durable polymer EES were carefully 
      searched. The cardiovascular outcomes were assessed during a follow-up time 
      period of 1 year and more than 1 year (1-5 years) respectively. This 
      meta-analysis was carried out by the latest version of the RevMan software. 
      Following analysis, the results were represented by odds ratios (OR) with 95% 
      confidence intervals (CI). RESULTS: A total number of 1967 patients with T2DM 
      were included in this analysis. During a 1 year follow-up time period, target 
      lesion failure (TLF) (OR: 0.59, 95% CI: 0.34-1.02; P = .06, target vessel 
      revascularization (TVR) (OR: 0.97, 95% CI: 0.55-1.70; P = .91) and target lesion 
      revascularization (TLR) (OR: 0.91, 95% CI: 0.44-1.87; P = .79) were similarly 
      observed with ultrathin bioresorbable polymer SES versus the thin, durable 
      polymer EES in these patients with T2DM. Other cardiovascular outcomes including 
      myocardial infarction (MI), major adverse cardiac events, all-cause mortality 
      (OR: 0.72, 95% CI: 0.37-1.40; P = .34), cardiac death and stent thrombosis (OR: 
      0.85, 95% CI: 0.45-1.62; P = .63) were also similarly observed with these 2 types 
      of new stents. During a follow-up time period above 1 year (1-5 years), still no 
      significant difference was observed in TLF, TVR, TLR, major adverse cardiac 
      events, MI, all-cause mortality, cardiac death and stent thrombosis (OR: 0.62, 
      95% CI: 0.33-1.16; P = .14). CONCLUSIONS: The ultrathin bioresorbable polymer SES 
      were similar to the durable polymer EES in these patients with T2DM. These 2 
      types of new generation stents were comparable in terms of cardiovascular 
      outcomes. Hence, they might be recommended in patients with T2DM. Upcoming trials 
      should be able to confirm this hypothesis.
CI  - Copyright (c) 2020 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Deng, Shibing
AU  - Deng S
AD  - Department of Internal Medicine, The First Clinical Medical College of Yangtze 
      University.
FAU - Yi, Xuying
AU  - Yi X
AD  - Department of Internal Medicine, The First People's Hospital of Jingzhou, 
      Jingzhou, Hubei, China.
FAU - Tian, Zhiming
AU  - Tian Z
AUID- ORCID: 0000-0002-5463-2789
AD  - Department of Internal Medicine, The First Clinical Medical College of Yangtze 
      University.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Immunosuppressive Agents)
RN  - 9HW64Q8G6G (Everolimus)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Absorbable Implants/*adverse effects
MH  - Cardiovascular Diseases/*epidemiology
MH  - Coronary Artery Disease/complications/*surgery
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Drug-Eluting Stents/*adverse effects
MH  - Everolimus/*pharmacology
MH  - Humans
MH  - Immunosuppressive Agents/pharmacology
MH  - Outcome Assessment, Health Care
MH  - Percutaneous Coronary Intervention/*instrumentation
MH  - Sirolimus/*pharmacology
PMC - PMC7769319
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/12/23 06:00
MHDA- 2021/01/16 06:00
PMCR- 2020/12/24
CRDT- 2020/12/22 11:22
PHST- 2020/03/08 00:00 [received]
PHST- 2020/11/19 00:00 [accepted]
PHST- 2020/12/22 11:22 [entrez]
PHST- 2020/12/23 06:00 [pubmed]
PHST- 2021/01/16 06:00 [medline]
PHST- 2020/12/24 00:00 [pmc-release]
AID - 00005792-202012240-00049 [pii]
AID - MD-D-20-02123 [pii]
AID - 10.1097/MD.0000000000023810 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Dec 24;99(52):e23810. doi: 
      10.1097/MD.0000000000023810.