Conflict of interest: Nothing to report.
E-ONLY: Coronary Artery Disease
Comparable clinical safety and efficacy of biodegradable versus durable polymer paclitaxel eluting stents despite shorter dual antiplatelet therapy: Insights from a multicenter, propensity score-matched registry
Article first published online: 3 DEC 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 82, Issue 3, pages E155–E162, 1 September 2013
How to Cite
Buszman, P. P., Orlik, B., Trela, B., Milewski, K., Kozlowski, M., Pruski, M., Drzewiecki, J., Peppas, A., Granada, J. F., Kaluza, G. L. and Buszman, P. E. (2013), Comparable clinical safety and efficacy of biodegradable versus durable polymer paclitaxel eluting stents despite shorter dual antiplatelet therapy: Insights from a multicenter, propensity score-matched registry. Cathet. Cardiovasc. Intervent., 82: E155–E162. doi: 10.1002/ccd.24732
- Issue published online: 26 AUG 2013
- Article first published online: 3 DEC 2012
- Accepted manuscript online: 29 OCT 2012 03:07AM EST
- Manuscript Accepted: 16 OCT 2012
- Manuscript Received: 10 JUL 2012
- biodegradable polymer;
- durable polymer;
- paclitaxel eluting stent;
- double anti-platelet therapy
The biodegradable polymer drug-eluting stents have been proposed as an alternative to durable polymer DES, theoretically improving vessel healing and reducing the need for prolonged double anti platelet therapy (DAPT), however clinical significance of this technology is under debate. Therefore, we sought to compare the clinical outcomes of two Paclitaxel eluting stents (PES) containing different polymer-based eluting matrices.
In this multicenter registry of 392 consecutive patients who underwent PCI between June 2006 and September 2008, we included patients with stable angina or NSTE-ACS displaying at least one significant lesion (>50% diameter stenosis) in native coronary arteries.
Biodegradable polymer PES (BP-PES, LUC Chopin2, Balton, Poland) was implanted in 206 patients, whereas durable polymer PES (DP-PES, Taxus, Boston Scientific, USA) was implanted in 186 patients. There were no significant differences in baseline characteristics between groups with the exception of increased diabetes and number of lesions for BP-PES. In risk-unadjusted analysis at 1-year follow-up, there were no significant differences in TLR (BP-PES: 8.4% vs. DP-PES: 6%; P = 0.36), TVR (BP-PES: 11.1% vs. DP-PES: 8.4%; P = 0.36) and incidence of stent thromboses (BP-PES: 2.15% vs. DP-PES: 3.4%; P = 0.42) between groups. There was also no difference in MACCE between groups (17.6% vs. 14.4%, P = 0.49). The mean dual antiplatelet therapy (DAPT) compliance at 1 year was 77% for BP-PES versus 92% for DP-PES (P = 0.03). Kaplan–Meier analysis showed a significantly higher long-term stroke free survival in BP-PES (P = 0.04). After adjustment, this was sustained with an additional tendency toward higher MI free survival for BP-PES (P = 0.059).
In this observational analysis, BP-PES were comparable to DP-PES, with regard to incidence of repeated revascularizations, stent thromboses and MACCE despite earlier DAPT discontinuation. © 2012 Wiley Periodicals, Inc.