Long-term Outcomes Following Ultrathin Vs Thin-strut Drug-eluting Stents for Percutaneous Coronary Intervention: an Updated Systematic Review and Meta-analysis of Randomized Control Trials

Overview

Journal Am J Cardiovasc Dis

Specialty Cardiology & Vascular Diseases

Date 2024 Nov 25

PMID 39583995

Authors

Farah Yasmin

Syeda Farwa Zaidi

Abdul Moeed

Muneeba Khan

Eman Ali

Muhammad Sohaib Asghar

Waqas Ullah

Michael P Savage

Alec Vishnevsky

Nicholas J Ruggiero

David L Fischman

Affiliations

Soon will be listed here.

Abstract

Objectives: Current thin-strut 2 generation drug eluting stents (DES) are considered as optimal standard of care for revascularization of coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). Ultrathin (≤ 70 μm strut thickness) strut DES have recently been shown to reduce target lesion failure (TLF) compared to thin-strut DES. Therefore, in order to assess the validity of improved outcomes associated with ultrathin-strut DES, we conducted an updated meta-analysis that includes recently published follow-ups of previously conducted randomized controlled trials (RCTs).

Methods: MEDLINE and Scopus were queried from their inception to May 2024 to identify studies comparing outcomes between ultrathin and current thin-strut 2 generation DES groups. A random-effects meta-analysis was conducted to derive risk ratios (RR) from dichotomous data. The primary endpoint was long-term TLF defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and clinically driven target lesion revascularization (CD-TLR). The secondary outcome was target-vessel failure (TVF) defined as a composite of cardiac death, TV-MI and clinically driven target-vessel revascularization (CD-TVR).

Results: A total of 17 RCTs (n=22141) with a mean follow-up of 34 months were included. The risk of TLF was significantly lowered in the ultrathin DES group in comparison to thin-strut DES. A significant decrease was also noted in rates of TVF, CD-TLR and CD-TVR in the ultrathin DES vs thin-strut DES group.

Conclusion: The results of our analysis demonstrate a significantly reduced risk of TLF in the ultrathin DES group in comparison with thin-strut DES. Ultrathin DES was also associated with a significantly decreased risk of TVF, CD-TLR and CD-TVR.

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