Durable versus biodegradable polymer drug-eluting stents in all-comers
Background Drug-eluting stents (DESs) have become the gold standard of coronary angioplasty since their inception in 2002. Biodegradable polymer DESs (BP-DESs) have been postulated to be superior to durable polymer DESs (DP-DESs) due to their more biocompatible polymer. To date, no study has shown t...
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BMJ Publishing Group
2025-03-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003104.full |
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| author | Pascal Meier Stéphane Cook MARIO TOGNI Serban Puricel Diego Arroyo Thierry Witzig Alain Witzig |
| author_facet | Pascal Meier Stéphane Cook MARIO TOGNI Serban Puricel Diego Arroyo Thierry Witzig Alain Witzig |
| author_sort | Pascal Meier |
| collection | DOAJ |
| description | Background Drug-eluting stents (DESs) have become the gold standard of coronary angioplasty since their inception in 2002. Biodegradable polymer DESs (BP-DESs) have been postulated to be superior to durable polymer DESs (DP-DESs) due to their more biocompatible polymer. To date, no study has shown the superiority of one type of polymer compared with the other. We aimed to compare outcomes between a broad range of second-generation DP-DES and BP-DES in an all-comer population.Methods We analysed data from 2824 patients who underwent percutaneous coronary intervention (PCI) with BP-DES or DP-DES in the Cardio-FR database. Of these, 2079 (1286 DP-DES and 793 BP-DES) met the inclusion and exclusion criteria and completed a 2-year follow-up: The primary outcome was the device-oriented composite endpoint (DOCE) of cardiac death, non-fatal target vessel myocardial infarction and target lesion revascularisation.Results Mean age was 67 years, with 75% male. Despite the DP-DES group exhibiting significantly higher rates of risk factors, such as arterial hypertension (63.1% vs 57.5%, p=0.010), a greater average number of stents implanted per patient (1.72±0.92 vs 1.63±0.84, p=0.040), more acute coronary syndrome (ACS) (55.1% vs 50.2%, p=0.031) and a higher rate of post-dilatation (42.2% vs 35.2%, p<0.001), the rate of acute stent thrombosis (ST) was significantly lower than in the BP-DES group (HR 0.240, 95% CI 0.075 to 0.766; p=0.016). This difference remained significant even after adjusting for covariates using a Cox proportional hazards model and performing a win ratio analysis (4.09, 95% CI 1.28 to 13.09; p=0.018). Despite this increased rate of acute ST, there was no difference in DOCE (12.1% vs 14.5%, OR 1.218, 95% CI 0.926 to 1.600; p=0.158) between the two groups up to 2 years.Conclusion Clinical follow-up up to 2 years shows similar outcomes between BP-DES and DP-DES. The rate of acute ST is higher in patients with BP-DES. |
| format | Article |
| id | doaj-art-a63ce678647f4e9a8e698bc35c3e0b24 |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-a63ce678647f4e9a8e698bc35c3e0b242025-08-20T02:02:10ZengBMJ Publishing GroupOpen Heart2053-36242025-03-0112110.1136/openhrt-2024-003104Durable versus biodegradable polymer drug-eluting stents in all-comersPascal Meier0Stéphane Cook1MARIO TOGNI2Serban Puricel3Diego Arroyo4Thierry Witzig5Alain Witzig6Cardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandCardiology, University & Hospital Fribourg, Fribourg, SwitzerlandBackground Drug-eluting stents (DESs) have become the gold standard of coronary angioplasty since their inception in 2002. Biodegradable polymer DESs (BP-DESs) have been postulated to be superior to durable polymer DESs (DP-DESs) due to their more biocompatible polymer. To date, no study has shown the superiority of one type of polymer compared with the other. We aimed to compare outcomes between a broad range of second-generation DP-DES and BP-DES in an all-comer population.Methods We analysed data from 2824 patients who underwent percutaneous coronary intervention (PCI) with BP-DES or DP-DES in the Cardio-FR database. Of these, 2079 (1286 DP-DES and 793 BP-DES) met the inclusion and exclusion criteria and completed a 2-year follow-up: The primary outcome was the device-oriented composite endpoint (DOCE) of cardiac death, non-fatal target vessel myocardial infarction and target lesion revascularisation.Results Mean age was 67 years, with 75% male. Despite the DP-DES group exhibiting significantly higher rates of risk factors, such as arterial hypertension (63.1% vs 57.5%, p=0.010), a greater average number of stents implanted per patient (1.72±0.92 vs 1.63±0.84, p=0.040), more acute coronary syndrome (ACS) (55.1% vs 50.2%, p=0.031) and a higher rate of post-dilatation (42.2% vs 35.2%, p<0.001), the rate of acute stent thrombosis (ST) was significantly lower than in the BP-DES group (HR 0.240, 95% CI 0.075 to 0.766; p=0.016). This difference remained significant even after adjusting for covariates using a Cox proportional hazards model and performing a win ratio analysis (4.09, 95% CI 1.28 to 13.09; p=0.018). Despite this increased rate of acute ST, there was no difference in DOCE (12.1% vs 14.5%, OR 1.218, 95% CI 0.926 to 1.600; p=0.158) between the two groups up to 2 years.Conclusion Clinical follow-up up to 2 years shows similar outcomes between BP-DES and DP-DES. The rate of acute ST is higher in patients with BP-DES.https://openheart.bmj.com/content/12/1/e003104.full |
| spellingShingle | Pascal Meier Stéphane Cook MARIO TOGNI Serban Puricel Diego Arroyo Thierry Witzig Alain Witzig Durable versus biodegradable polymer drug-eluting stents in all-comers Open Heart |
| title | Durable versus biodegradable polymer drug-eluting stents in all-comers |
| title_full | Durable versus biodegradable polymer drug-eluting stents in all-comers |
| title_fullStr | Durable versus biodegradable polymer drug-eluting stents in all-comers |
| title_full_unstemmed | Durable versus biodegradable polymer drug-eluting stents in all-comers |
| title_short | Durable versus biodegradable polymer drug-eluting stents in all-comers |
| title_sort | durable versus biodegradable polymer drug eluting stents in all comers |
| url | https://openheart.bmj.com/content/12/1/e003104.full |
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