Durable-polymer versus biodegradable-polymer drug-eluting stents in acute coronary syndromes: three-year outcomes of the HOST REDUCE POLYTECH RCT Trial.
EuroIntervention
; 20(12): e750-e759, 2024 Jun 17.
Article
in En
| MEDLINE
| ID: mdl-38887886
ABSTRACT
BACKGROUND:
Long-term follow-up is essential to evaluate the impact of polymer degradation in drug-eluting stents (DES).AIMS:
We aimed to compare durable-polymer DES (DP-DES) and biodegradable-polymer DES (BP-DES) during a 3-year follow-up to evaluate the entire period of polymer resolution (before, during, and after degradation).METHODS:
The HOST REDUCE POLYTECH RCT Trial was a randomised clinical trial enrolling patients with acute coronary syndrome (ACS) and comparing the efficacy and safety of DP-DES and BP-DES. The primary outcome was a patient-oriented composite outcome (POCO), and the key secondary outcome was a device-oriented composite outcome (DOCO).RESULTS:
A total of 3,413 ACS patients were randomised to either the DP-DES (1,713 patients) or BP-DES (1,700 patients) group. During the 3-year follow-up, the risk of the POCO was similar between the DP-DES and BP-DES groups (14.8% vs 15.4%, hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.80-1.14; p=0.613). However, the risk of the DOCO was lower in the DP-DES group (6.0% vs 8.0%, HR 0.73, 95% CI 0.57-0.95; p=0.020). In a landmark analysis, the lower risk of the DOCO for the DP-DES group was evident during the transition from the early to the late period after percutaneous coronary intervention (PCI) (from 8 to 16 months post-PCI; 1.8% vs 3.3%, HR 0.54, 95% CI 0.34-0.84; p=0.007), which was mainly driven by a risk reduction of target lesion revascularisation.CONCLUSIONS:
In ACS patients, DP-DES showed similar results to BP-DES regarding the POCO up to 3 years. For the DOCO, DP-DES were superior to BP-DES; this was due to the higher event rate during the period of polymer degradation.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Polymers
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Absorbable Implants
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Acute Coronary Syndrome
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Drug-Eluting Stents
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Percutaneous Coronary Intervention
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
EuroIntervention
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
TERAPEUTICA
Year:
2024
Document type:
Article
Country of publication: