Multivessel percutaneous coronary intervention with thin-strut biodegradable versus durable polymer drug-eluting stents in ST-segment-elevation myocardial infarction: A subgroup analysis of the BIOSTEMI randomized trial.

Iglesias, Juan F; Muller, Olivier; Losdat, Sylvain; Roffi, Marco; Kurz, David J; Weilenmann, Daniel; Kaiser, Christoph; Heg, Dik; Valgimigli, Marco; Windecker, Stephan; Pilgrim, Thomas (2021). Multivessel percutaneous coronary intervention with thin-strut biodegradable versus durable polymer drug-eluting stents in ST-segment-elevation myocardial infarction: A subgroup analysis of the BIOSTEMI randomized trial. International journal of cardiology, 334, pp. 37-41. Elsevier 10.1016/j.ijcard.2021.04.034

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BACKGROUND

Randomized evidence comparing newer-generation drug-eluting stents for multivessel percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is limited. We sought to investigate clinical outcomes in STEMI patients undergoing multivessel PCI with thin-strut biodegradable polymer sirolimus-eluting stents (BP-SES) versus durable polymer everolimus-eluting stents (DP-EES).

METHODS

We performed a subgroup analysis of the BIOSTEMI (NCT02579031) randomized trial, which included individual patient data from STEMI patients enrolled into the BIOSCIENCE (NCT02579031) study. STEMI patients randomly allocated to BP-SES or DP-EES were divided into those undergoing multivessel versus culprit lesion-only PCI. The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target-vessel myocardial re-infarction or clinically-indicated target lesion revascularization (TLR), within 24 months.

RESULTS

Among 1707 STEMI patients, 145 patients underwent multivessel PCI. At 2 years, TLF occurred in 2 patients (2.8%) treated with BP-SES and 13 patients (18.7%) treated with DP-EES (hazard ratio [HR], 0.14; 95% confidence interval (CI), 0.03-0.61; p = 0.009) in the multivessel PCI group, and in 40 (5.3%) and 61 (8.2%) patients treated with BP-SES and DP-EES respectively (HR, 0.64; 95%CI, 0.43-0.96; p = 0.03; p for interaction = 0.050) in the culprit lesion-only PCI group. In the multivessel PCI group, the rates of clinically-indicated TLR (0% vs. 12.4%) and target-vessel myocardial re-infarction (0% vs. 4.6%) at 2 years were lower in patients treated with BP-SES compared with DP-EES.

CONCLUSION

In a subgroup analysis of the BIOSTEMI trial, BP-SES were associated with lower 2-year TLF rates compared to DP-EES in STEMI patients undergoing multivessel PCI.

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:

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

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

27 Apr 2021 17:58

Last Modified:

02 Jun 2021 01:34

Publisher DOI:

10.1016/j.ijcard.2021.04.034

PubMed ID:

33887341

Uncontrolled Keywords:

Biodegradable polymer Drug-eluting stent Multivessel coronary artery disease ST-segment elevation myocardial infarction

BORIS DOI:

10.48350/156080

URI:

https://boris.unibe.ch/id/eprint/156080

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