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Safety and efficacy of the polymer-free and polymer-coated drug-eluting stents in patients undergoing percutaneous coronary intervention.

Ullah, Waqas; Zghouzi, Mohamed; Ahmad, Bachar; Suleiman, Abdul-Rahman M.; Zahid, Salman; Faisaluddin, Mohammed; Alabdalrazzak, Mukhlis; Sattar, Yasar; Kalra, Ankur; Kapadia, Samir; Fischman, David L.; Brilakis, Emmanouil S.; Mamas, Mamas A.; Alraies, M. Chadi


Waqas Ullah

Mohamed Zghouzi

Bachar Ahmad

Abdul-Rahman M. Suleiman

Salman Zahid

Mohammed Faisaluddin

Mukhlis Alabdalrazzak

Yasar Sattar

Ankur Kalra

Samir Kapadia

David L. Fischman

Emmanouil S. Brilakis

M. Chadi Alraies


INTRODUCTION: The relative safety and efficacy of polymer-free (PF) versus polymer-coated (PC) drug-eluting stents (DES) in patients with angina or acute coronary syndrome (ACS) undergoing percutaneous coronary intervention has received limited study. METHOD: Digital databases were queried to identify relevant studies. Major adverse cardiovascular events (MACE) and secondary outcomes were compared using a random effect model to calculate unadjusted odds ratios (OR). RESULTS: A total of 28 studies consisting of 23,198 patients were included in the final analysis. On pooled analysis, there was no significant difference in the odds of MACE (OR 0.98, 95% CI 0.91-1.08) and major bleeding (OR 0.87, 95% CI 0.61-1.24) between patients undergoing PF-DES versus PC-DES. Similarly, the odds of myocardial infarction, stroke, stent thrombosis, cardiovascular mortality and need for target vessel revascularization was similar between the two groups. PF-DES was favored due to significantly lower odds of non-cardiac death (OR 0.78, 95% CI 0.68-89) and all-cause mortality (OR 0.87, 95% CI 0.80-0.95), but had a higher need for target lesion revascularization (OR 1.2, 95% CI 1.02-1.42). A subgroup analysis based on follow up duration, clinical presentation, presence of diabetes and class of eluting drugs mirrored the net estimates for all outcomes with a few exceptions. A sensitivity and meta-regression analysis showed no influence of single-study and duration of antiplatelet therapy on pooled outcomes. CONCLUSION: In patients presenting with angina or ACS, PF-DES might be favored due to lower all-cause mortality and equal risk of ischemic adverse cardiovascular and major bleeding events compared with PC-DES.


Ullah, W., Zghouzi, M., Ahmad, B., Suleiman, A. M., Zahid, S., Faisaluddin, M., …Alraies, M. C. (2021). Safety and efficacy of the polymer-free and polymer-coated drug-eluting stents in patients undergoing percutaneous coronary intervention. Catheterization and Cardiovascular Interventions, 98(6), E802 - E813.

Journal Article Type Article
Acceptance Date Sep 3, 2021
Online Publication Date Sep 12, 2021
Publication Date Nov 15, 2021
Journal Catheterization and Cardiovascular Interventions
Print ISSN 1522-1946
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 98
Issue 6
Pages E802 - E813
Keywords Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and imaging, General Medicine
Publisher URL