Unselected Use of Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent for Coronary Revascularization.

Yamaji, Kyohei; Zanchin, Thomas; Zanchin, Christian; Stortecky, Stefan; Koskinas, Konstantinos C; Hunziker, Lukas; Praz, Fabien; Blöchlinger, Stefan; Moro, Christina; Moschovitis, Aris; Seiler, Christian; Valgimigli, Marco; Billinger, Michael; Pilgrim, Thomas; Heg, Dik; Windecker, Stephan; Räber, Lorenz (2018). Unselected Use of Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent for Coronary Revascularization. Circulation: Cardiovascular interventions, 11(9), e006741. Lippincott Williams & Wilkins 10.1161/CIRCINTERVENTIONS.118.006741

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BACKGROUND Biodegradable polymer sirolimus-eluting stents (BP-SESs) have been reported to be noninferior compared with durable polymer everolimus-eluting stents (DP-EES) in a randomized clinical trial. We sought to compare the efficacy and safety of an ultrathin strut BP-SES with a DP-EES in an all-comers population. METHODS AND RESULTS Among 7640 consecutive patients who underwent percutaneous coronary intervention between March 2011 and June 2015, 4638 patients were exclusively treated with BP-SES (N=1896; 3137 lesions) or DP-EES (N=2742; 4468 lesions). After propensity score matching within strata of clinical indications, the final study population consisted of 2902 matched patients (BP-SES 2406 lesions and DP-EES 2368 lesions). The primary device-oriented composite end point (DOCE) included cardiac death, target vessel myocardial infarction, and target lesion revascularization at 1 year. BP-SES (6.9%) was noninferior to DP-EES (8.0%) with respect to device-oriented composite end point (hazard ratio [HR], 0.85; 95% CI, 0.65-1.11; P for noninferiority <0.001; P for superiority=0.24). No differences in cardiac death (BP-SES, 2.3% versus DP-EES, 3.0%; HR, 0.76; 95% CI, 0.49-1.20; P=0.25), myocardial infarction (BP-SES, 4.6% versus DP-EES, 4.6%; HR, 1.00; 95% CI, 0.71-1.40; P=0.99), or target lesion revascularization (BP-SES, 2.8% versus DP-EES, 2.5%; HR, 1.11; 95% CI, 0.71-1.74; P=0.65) were observed. The rate of periprocedural myocardial infarction was comparable between the 2 groups (2.1% versus 2.2%; HR, 0.97; 95% CI, 0.59-1.58; P=0.89). The rate of definite stent thrombosis was similarly low throughout 1 year (BP-SES, 0.8% versus DP-EES, 0.8%; HR, 1.00; 95% CI, 0.45-2.22; P=1.00). CONCLUSIONS In a consecutively enrolled percutaneous coronary intervention population reflecting routine clinical practice, BP-SES was noninferior to DP-EES for device-oriented composite end point at 1 year. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov . Unique identifier: NCT02241291.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Yamaji, Kyohei; Zanchin, Christian; Stortecky, Stefan; Koskinas, Konstantinos; Hunziker, Lukas; Praz, Fabien; Blöchlinger, Stefan; Moschovitis, Aris; Seiler, Christian; Valgimigli, Marco; Billinger, Michael; Pilgrim, Thomas; Heg, Dierik Hans; Windecker, Stephan and Räber, Lorenz

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1941-7632

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

16 Nov 2018 14:03

Last Modified:

19 Nov 2018 15:52

Publisher DOI:

10.1161/CIRCINTERVENTIONS.118.006741

PubMed ID:

30354590

Uncontrolled Keywords:

coronary artery disease drug-eluting stents stents thrombosis

BORIS DOI:

10.7892/boris.121283

URI:

https://boris.unibe.ch/id/eprint/121283

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