ArticleAsiaIntervention2026
Biolimus- versus sirolimus-eluting stents in percutaneous coronary intervention: a comprehensive systematic review and meta-analysis of randomised controlled trials.
Article in AsiaIntervention, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
14 authors.
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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. Results: Six trials (12,109 patients: 6,088 BES, 6,021 SES) were analysed. BES reduced 1-year cardiac death by 30% (RR 0.70, 95% CI: 0.52-0.93) and showed a non-significant 19% reduction in all-cause death (RR 0.81; p=0.058). MACE, myocardial infarction, and TLR were similar between stents across timepoints. BES showed a non-significant early increase in ST (RR 1.85; p=0.12) but a 46% reduction in late ST (RR 0.54, 95% CI: 0.33-0.88). Mortality rates converged after 1 year. Conclusions: BES offer a short-term reduction in cardiac mortality and late stent thrombosis compared with SES, with otherwise similar morbidity outcomes. These results support the short-term safety of BES and indicate a possible long-term thrombotic and cardiac survival benefit, warranting confirmation in longer-term trials.
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