# TiNO-stents versus DES bij ACS: IPD meta-analyse

*geplaatst 2025-06-09 · Algemeen · European heart journal · doi 10.1093/eurheartj/ehaf098 · https://hartvaat.nl/2025/06/09/tino-stents-versus-des-bij-acs-ipd-meta-analyse/*

IPD meta-analyse vergeleek titanium-nitrideoxide-gecoate stents met drug-eluting stents bij ACS. De coating-only stents gaven vergelijkbare resultaten, wat ze een alternatief maakt bij DAPT-beperking.

## English: Titanium-nitride-oxide-coated vs. drug-eluting stents in acute coronary syndromes: an individual patient data meta-analysis.

An individual patient data meta-analysis compared titanium-nitride-oxide-coated stents with drug-eluting stents in acute coronary syndromes over 5 years. TiNO stents showed comparable outcomes, offering an alternative when prolonged dual antiplatelet therapy is contraindicated.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: In acute coronary syndromes (ACS), vascular healing at the site of implantation of drug-eluting stents (DES) can be delayed. Titanium-nitride-oxide-coated stents (TiNOS) demonstrate faster strut coverage without the excessive intimal hyperplasia observed with bare metal stents. The 5-year outcomes of patients presenting with ACS, randomized to receive either TiNOS or DES, were compared. METHODS: A systematic review and individual participant data meta-analysis of trials comparing TiNOS with DES for the treatment of ACS was conducted (PROSPERO: CRD42024514342). The primary endpoint was major adverse cardiac events (MACE) at 5 years, a composite of cardiac death (CD), myocardial infarction (MI), and ischaemia-driven target lesion revascularization (TLR). Pre-specified secondary endpoints included CD, MI, TLR, and stent thrombosis. Data were pooled using a mixed-effects Cox regression model with random slope and stratified baseline hazards. RESULTS: Patient-level data (n = 2743) were obtained from three randomized controlled trials (TiNOS: n = 1620 vs. DES: n = 1123). After a median follow-up of 4.93 years, there was no significant difference in the primary endpoint between TiNOS and DES (12.6% vs. 16.2%; hazard ratio [HR] .82, 95% confidence interval [CI] .67-1.00, P = .051), mainly due to a similar rate of TLR (8.0% vs. 8.1%; HR 1.05, 95% CI .80-1.38, P = .733). However, TiNOS was associated with significantly lower rates of CD (1.5% vs. 3.7%; HR .46, 95% CI .26-.81, P = .007), MI (5.2% vs. 9.6%; HR .56, 95% CI .42-.75, P < .001), and stent thrombosis (1.1% vs. 3.8%; HR .30, 95% CI .17-.53, P < .001). CONCLUSIONS: In ACS patients, TiNOS was associated with similar rates of MACE and TLR as compared with DES but significantly lower rates of CD, MI, and stent thrombosis.

Auteurs: Thabo Mahendiran, Frederic Bouisset, Pim Tonino, Nico H J Pijls, Jussi Sia, Kari Kervinen, Fernando Rivero-Crespo, Peter Jüni, Bruno Roza da Costa, Carlos Collet, Takuya Mizukami, Pasi Karjalainen, Bernard De Bruyne

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehaf098. Bijgewerkt 2026-07-03T13:30:40Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.