Percutaneous Coronary Intervention With Ridaforolimus-Eluting Stents in Patients With Coronary Artery Disease: A Systematic Review and Single-Arm Meta-Analysis

Abstract

Background:

The ridaforolimus-eluting stent (RES) is a new-generation drug-eluting stent (DES) featuring thin struts and a durable polymer, designed to provide a high therapeutic-to-toxicity margin. However, its long-term clinical performance remains uncertain.

Methods:

We conducted a systematic review and meta-analysis following Cochrane and PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) and prospective non-RCT studies evaluating RES in patients with coronary artery disease (CAD). Outcomes were expressed as event rates using a generalized linear mixed model (GLMM). Statistical significance was defined as P < 0.05.

Results:

Six studies with eight reports and 1,709 patients were included. The mean age was 63 years; 76% were men; 35% had a previous myocardial infarction (MI); and 41% presented with acute coronary syndrome. Mean lesion length was 27.84 mm, and ACC/AHA lesion class B2/C accounted for 61% of lesions. Target lesion failure (TLF) was 3.89% (95% confidence intervals [CI]: 2.58–5.82) at 1 year and 11.73% (95% CI: 9.94–13.73) at 5 years. Major adverse cardiac events (MACE) occurred in 4.82% (95% CI: 3.19–7.21) at 1 year and 16.22% (95% CI: 14.14–18.47) at 5 years. Cardiovascular mortality remained low, at 0.59% (95% CI: 0.28–1.02) at one year and 3.36% (95% CI: 2.40–4.57) at 5 years. MI occurred in 2.68% (95% CI: 1.50–4.76) at 1 year and 9.84% (95% CI: 8.18–11.70) at five years.

Conclusion:

In this single-arm meta-analysis, RES was associated with high procedural success and low observed rates of adverse clinical events across available studies.