One hundred and twenty-six RCTs (106,427 patients) were included in the review. Seventy-five were assessed as being at low risk of bias. Mean follow-up was 2.3 years (range 0.5 to 5 years) with a total of 258,544 patient-years of follow-up.
Biodegradable polymer drug-eluting stents were associated with significant reductions in the risk of target vessel revascularization compared to paclitaxel-eluting stents (RR 0.66, 95% CrI 0.57 to 0.78) and zotarolimus-eluting stent-Endeavour (RR 0.69, 95% CrI 0.56 to 0.84) but not to cobalt chromium everolimus-eluting stents (RR 1.03, 95% CrI 0.89 to 1.21). Results were similar for sensitivity analyses. Statistical heterogeneity was low.
For long-term safety outcome of stent thrombosis, biodegradable polymer drug-eluting stents were significantly superior to paclitaxel-eluting stents (RR 0.61, 95% CrI 0.37 to 0.89) but were significantly inferior to cobalt chromium everolimus-eluting stents (RR 2.04, 95% CrI 1.27 to 3.35). Results of sensitivity analyses were similar.
In the landmark analysis after one year, biodegradable polymer drug-eluting stents were significantly superior to sirolimus-eluting stents for definite stent thrombosis (RR 0.29, 95% CrI 0.10 to 0.82) but were associated with increased mortality compared with cobalt chromium everolimus-eluting stents (RR 1.52, 95% CrI 1.02 to 2.22).
Further results were reported in the article and appendices.