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

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, Mamas A. Mamas, M. Chadi Alraies

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)E802-E813
JournalCatheterization and Cardiovascular Interventions
Issue number6
StatePublished - Nov 15 2021
Externally publishedYes


  • ACS
  • PC
  • PF
  • acute coronary syndrome
  • drug-eluting stent
  • polymer coated
  • polymer free

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Safety and efficacy of the polymer-free and polymer-coated drug-eluting stents in patients undergoing percutaneous coronary intervention'. Together they form a unique fingerprint.

Cite this