AIMS: Several studies suggest good procedural and similar clinical outcomes between everolimus-eluting bioresorbable stents (BRS) ABSORB versus conventional drug-eluting stents (DES), but the evidence is not definitive. We performed a systematic review and meta-analysis to investigate the effects of BRS versus conventional drug eluting and bare metallic stents on the cardiovascular endpoints and all-cause mortality.
METHODS AND RESULTS: The follow-up in the included studies was up to 13 months. The following endpoints were evaluated: all-cause mortality, cardiac death, patient-oriented major adverse cardiac events (POCE), device-oriented major adverse cardiac events (DOCE), any cause myocardial infarction (MI), target vessel MI (TVMI), target vessel revascularization (TVR) and target lesion revascularization (TLR). The results of 10 studies with 5773 subjects showed statistically significant increase in risk of TVMI between BRS and conventional stents (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.03, 2.05, p=0.032). None of the other differences reached statistical significance: all-cause mortality (OR: 0.67, 95%CI: 0.30, 1.49, p=0.333), cardiac death (OR: 1.00, 95%CI: 0.47, 2.12, p=0.996), POCE (OR: 0.91, 95%CI: 0.68, 1.22, p=0.546), DOCE (OR: 1.12, 95%CI: 0.86, 1.46, p=0.387), any-cause MI (OR: 1.34, 95%CI: 0.98, 1.82, p=0.064), TVR (OR: 0.99, 95%CI: 0.73, 1.33, p=0.934) and TLR (OR: 0.92, 95%CI: 0.66, 1.29, p=0.641). Similar results were observed after restricting the meta-analysis to the comparison of BRS vs EES.
CONCLUSIONS: Our meta-analysis suggests a significantly higher risk of TVMI with BRS compared with conventional stents and no significant differences in the rates of occurrence of the other outcomes during one-year follow-up. Further studies with larger samples sizes, longer follow-up, different clinical scenarios and more complex lesions, are required to confirm or refute our findings.