Comparison among ultra-thin coronary stents: a network meta-analysis.

BACKGROUND

Ultrathin-strut DES have been related to potential improvement in stent-related outcomes compared to thicker-struts drug-eluting stents (DESs). However, comparisons among different ultrathin devices are lacking.

METHODS

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 endpoint. Overall mortality, myocardial infarction, target lesion revascularization (TLR), and stent thrombosis were the secondary endpoints. Arms of included trials were compared by means of network meta-analysis.

RESULTS

Nine studies encompassing 20081 patients were included, of which 9509 patients had an ultrathin DES: Orsiro (evaluated in 7 arms with 8086 patients), MiStent (one arm with 703 patients), or Supraflex (one 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 (RR, 1.07; 95% confidence interval, 0.59-1.78) and showed the highest probability of performing best in terms of TLF, myocardial infarction and TLR.

CONCLUSIONS

Ultrathin DESs are all associated with a comparable risk of TLF as compared with thicker-strut DESs. In terms of TLR and TLF risk, Orsiro was the one with the highest probability of best performances, either compared to other ultrathin DESs or to devices with thicker struts.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: THOMAS PILGRIM reports a relationship with BIOTRONIK Inc that includes: funding grants.