Five-year outcomes with biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with acute coronary syndrome: A subgroup analysis of the BIOSCIENCE trial.

Iglesias, Juan F; Heg, Dik; Roffi, Marco; Degrauwe, Sophie; Tüller, David; Muller, Olivier; Brinkert, Miriam; Cook, Stéphane; Weilenmann, Daniel; Kaiser, Christoph; Cuculi, Florim; Valgimigli, Marco; Jüni, Peter; Windecker, Stephan; Pilgrim, Thomas (2021). Five-year outcomes with biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with acute coronary syndrome: A subgroup analysis of the BIOSCIENCE trial. (In Press). Cardiovascular revascularization medicine Elsevier 10.1016/j.carrev.2021.02.008

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BACKGROUND

Thin-strut biodegradable polymer sirolimus-eluting stents (BP-SES) have been shown to reduce target lesion failure (TLF) at one-year follow-up compared with durable polymer everolimus-eluting stents (DP-EES) among patients with acute coronary syndrome (ACS). The long-term clinical benefits of thin-strut BP-SES over DP-EES in ACS patients after complete degradation of the polymer coating remain uncertain.

METHODS

We performed a post-hoc subgroup analysis of ACS patients included into the BIOSCIENCE randomized trial (NCT01443104). The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target-vessel myocardial infarction or clinically indicated target lesion revascularization, at 5 years.

RESULTS

Among 2119 patients enrolled between March 2012 and May 2013, 1131 (53%) presented with ACS. The 5-year cumulative incidence of TLF was significantly lower in patients with ACS compared to chronic coronary syndrome [16.5% vs. 22.9%; rate ratio (RR), 0.69; 95% confidence interval (CI), 0.57-0.85; p < 0.001]. At 5 years, TLF occurred similarly in ACS patients treated with BP-SES and DP-EES (16.9% vs. 16.0%; RR, 1.04; 95% CI, 0.78-1.41; p = 0.78). The individual components of the primary endpoint did not differ between ACS patients treated with BP-SES or DP-EES at 5 years. Overall, there was no interaction between clinical presentation and treatment effect.

CONCLUSIONS

In a subgroup analysis of the BIOSCIENCE trial, we found no difference in long-term outcomes between ACS patients treated with BP-SES or DP-EES at 5 years.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Heg, Dierik Hans; Valgimigli, Marco; Windecker, Stephan and Pilgrim, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-8389

Publisher:

Elsevier

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

15 Mar 2021 10:34

Last Modified:

15 Mar 2021 10:34

Publisher DOI:

10.1016/j.carrev.2021.02.008

PubMed ID:

33653633

Uncontrolled Keywords:

Acute coronary syndrome Biodegradable polymer Clinical outcomes Drug-eluting stent

BORIS DOI:

10.48350/153392

URI:

https://boris.unibe.ch/id/eprint/153392

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