Long-term cardiovascular outcomes of biodegradable polymer drug eluting stents in patients with diabetes versus non-diabetes mellitus: a meta-analysis

Cardiovascular Diabetology

Review

Quannan Zu¹  Ming Lu¹  Hong Wang²  Hairong Tang²  Rongfa Chen³  Zhiren Yang³ 

[1] College of Management and Economics, Tianjin University, 300072, Tianjin, P. R. China;Department of Cardiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, 530021, Nanning, Guangxi, P. R. China;The State Key Laboratory Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, P. R. China;

关键词: Biodegradable polymer drug eluting stents;    Durable polymer drug eluting stents;    Percutaneous coronary intervention;    Diabetes mellitus;    Cardiovascular diseases;    Stent thrombosis;    Revascularization;   

DOI  :  10.1186/s12933-023-01962-w

 received in 2023-02-20, accepted in 2023-08-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundToday, diabetes mellitus (DM) has become a worldwide concern. DM is a major risk factor for the development of cardiovascular diseases (CVD). Eligible patients with CVD are treated invasively by percutaneous coronary intervention (PCI) whereby a stent is implanted inside the coronary vessel with the particular lesion to allow sufficient blood flow. Newer scientific research have shown that even though associated with a lower rate of re-stenosis, first-generation drug eluting stents (DES) were associated with a higher rate of late stent thrombosis. Recently, newer stents, namely biodegradable polymer DES (BP-DES) have been developed to overcome the safety issues of earlier generation DES. In this analysis we aimed to systematically compare the long term (≥ 12 months) adverse cardiovascular outcomes observed in DM versus non-DM patients who were implanted with BP-DES.MethodsCochrane central, MEDLINE (Subset PubMed), EMBASE, Web of Science, http://www.ClinicalTrials.gov and Google scholar were searched for relevant publications involving BP-DES in patients with DM versus non-DM and their associated adverse cardiovascular outcomes. The mean follow-up time period ranged from 12 to 120 months. Data analysis was carried out with the latest version of the RevMan software (version 5.4). Based on the Mantel-Haenszel test, risk ratios (RR) with 95% confidence intervals (CI) were calculated and used to represent the results following analysis.ResultsSeven (7) studies with a total number of 10,246 participants were included in this analysis. Stents which were implanted during PCI were BP-DES. Participants were enrolled from the year 2006 to 2013. Our current results showed that in patients who were implanted with BP-DES, the risks of major adverse cardiac events (RR: 1.30, 95% CI: 1.18–1.43; P = 0.00001), myocardial infarction (RR: 1.48, 95% CI: 1.14–1.93; P = 0.003), all-cause mortality (RR: 1.70, 95% CI: 1.29–2.23; P = 0.0002), cardiac death (RR: 1.93, 95% CI: 1.28–2.93; P = 0.002), target vessel revascularization (RR: 1.35, 95% CI: 1.03–1.77; P = 0.03), target lesion revascularization (RR: 1.28, 95% CI: 1.07–1.54; P = 0.007) and target lesion failure (RR: 1.79, 95% CI: 1.52–2.12; P = 0.00001) were significantly higher in the DM group. Definite and probable stent thrombosis (RR: 1.80, 95% CI: 1.28–2.55; P = 0.0009) were also significantly higher in the DM group.ConclusionsDiabetes mellitus was an independent risk factor associated with long term adverse cardiovascular outcomes following PCI with BP-DES.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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