Abstract 4146282: Safety and efficacy of the bioactive titanium-nitric-oxide coated stent in contrast to everolimus-eluting stents (EES) among patients diagnosed with ACS: An updated meta-analysis.

Introduction: Drug-eluting stents (DES) have effectively decreased the incidence of restenosis; however, recent investigations raised the potential for late stent thrombosis (LST). Bioactive stent (BAS) coated with titanium-nitride-oxide has demonstrated favourable outcomes with conflicting results in individuals with acute coronary syndromes. We aimed to outline the comparison of BAS and EES among patients diagnosed with acute coronary syndrome (ACS). Methods: We systematically searched PubMed, Web of Science, Scopus, and Cochrane Central, and EMBASE from inception until February 2024. We included randomised controlled trials (RCTs) and observational studies comparing bioactive titanium-nitric-oxide coated stent stents versus EES stents. The primary outcome was MACE, while secondary outcomes were MI, Cardiac death, All-Cause Death, definite stent thrombosis, and Minimal lumen diameter. All data were pooled as either Mean difference in the random effect model with the corresponding SD or pooled as RR and 95% CI for dichotomous data. Results: Seven RCTs involving 3101 patients were included in the analysis. BAS coated was associated with a reduction in definite stent thrombosis (OR= 0.35, 95% CI [ 0.16 to 0.77], P=0.009), MI (OR= 0.47, 95% CI [ 0.34 to 0.64], P=<0.001), and minimal lumen diameter (MD= -0.22, 95% CI [ -0.35 to -0.10], P=0.0004). However, there was no significant difference in terms of MACE, all-cause mortality, or cardiac mortality between the two studied approaches. Conclusion: BAS showed a reduction in definite stent thrombosis, MI, and minimal lumen diameter, with no significant difference in other reported outcomes. This opens the door for large-volume RCTs to validate the current findings.