1. Comparison Among Ultra-Thin Coronary Stents: A Network Meta-Analysis.
- Author
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Marengo G, Bruno F, Scudeler L, Savoca F, Zugna D, Isaevska E, Pilgrim T, Jensen LO, De Filippo O, Richiardi L, De Ferrari GM, and D'Ascenzo F
- Subjects
- Humans, Sirolimus, Network Meta-Analysis, Risk Factors, Absorbable Implants, Prosthesis Design, Treatment Outcome, Stents, Drug-Eluting Stents, Percutaneous Coronary Intervention, Myocardial Infarction epidemiology, Myocardial Infarction surgery, Coronary Artery Disease surgery
- Abstract
Ultrathin-strut drug-eluting stents (DES) have been related to potential improvement in stent-related outcomes compared with thicker-struts DES. However, comparisons among different ultrathin devices are lacking. All randomized controlled trials comparing ultrathin (struts thickness <70 µm) and thicker-struts DESs in an all-comers population were included. Target lesion failure (TLF), as defined by included trials, at 1-year follow-up was the primary end point. Overall mortality, myocardial infarction, target lesion revascularization (TLR), and stent thrombosis were the secondary end points. Arms of included trials were compared using network meta-analysis. Nine studies encompassing 20,081 patients were included, of which 9,509 patients had an ultrathin DES: Orsiro (evaluated in 7 arms with 8,086 patients), MiStent (1 arm with 703 patients), or Supraflex (1 arm with 720 patients). At 1-year follow-up, no significant differences were noted for TLF among these ultrathin DES. In particular, Orsiro was associated with a similar risk of TLF compared with Supraflex (risk rate 1.07, 95% confidence interval 0.59 to 1.78) and showed the highest probability of performing best in terms of TLF, myocardial infarction, and TLR. Ultrathin DES are all associated with a comparable risk of TLF compared with thicker-strut DES. In terms of TLR and TLF risk, Orsiro was the one with the highest probability of best performances, either compared with other ultrathin DES or to devices with thicker struts., Competing Interests: Declaration of competing interest Dr. Pilgrim received research grants to the institution from Biotronik, Edwards Lifesciences, and Boston Scientific, and speaker fees/consultancy from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, and HighLife SAS. The remaining authors have no competing interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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