AsiaIntervention
Biolimus- versus sirolimus-eluting stents in percutaneous coronary intervention: a comprehensive systematic review and meta-analysis of randomised controlled trials
By Suruagy-Motta RFO, Dexheimer da Silva L, Rezende Neves G and 11 others.
Abstract
Background
Sirolimus-eluting stents (SES) are a benchmark in percutaneous coronary intervention (PCI), while biolimus-eluting stents (BES), which combine a more lipophilic analogue with a biodegradable polymer, may enhance healing and reduce thrombosis. Whether these BES features translate into improved survival and cardiac outcomes compared with SES remains uncertain.
Aims
We sought to perform a meta-analysis of randomised controlled trials evaluating BES compared with SES in adult patients undergoing PCI.
Methods
This meta-analysis encompassed randomised and controlled clinical trials that directly compared BES with SES in the setting of percutaneous coronary intervention. A comprehensive literature search was performed across PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to June 2025. The main outcomes assessed were all-cause and cardiac mortality, while secondary endpoints included major adverse cardiovascular events (MACE), myocardial infarction, target lesion revascularisation (TLR), and stent thrombosis (ST). Outcomes were evaluated at <=1 year (early) and >1-5 years (midterm) using pooled risk ratios (RRs) with 95% confidence intervals (CIs) in random-effects models, with heterogeneity assessed by the I2 test.