Key result
Biodegradable polymer DES show no benefit over durable polymer DES for 5-year MACE.
Why the study?
Drug-eluting stents with polymer coatings improve long-term outcomes after PCI, but it is unclear if biodegradable polymer DES offer improved safety over durable polymer DES.
Do biodegradable polymer drug-eluting stents reduce the risk of major adverse cardiac events compared to durable polymer drug-eluting stents in patients undergoing percutaneous coronary intervention?
Cohort (n=2,118)
No
Do biodegradable polymer drug-eluting stents reduce the risk of major adverse cardiac events compared to durable polymer drug-eluting stents in patients undergoing percutaneous coronary intervention?
In a real-world setting, biodegradable polymer DES demonstrated similar 5-year overall cardiovascular safety to durable polymer DES, while offering a modest reduction in target lesion revascularization primarily in patients presenting with acute coronary syndrome.
Background: Percutaneous coronary intervention (PCI) is among the most common cardiovascular procedures, but stents still pose risks of restenosis or thrombosis. Drug-eluting stents (DES) with polymer coatings have improved long-term outcomes. Aim: This study evaluated whether the latest biodegradable polymer DES (BP-DES) offer improved safety over durable polymer DES (DP-DES). Methods: Data were collected from a single-centre registry at the Medical University of Vienna, including patients who underwent PCI between 2015 and 2020. Patients were categorized by stent type and PCI indication (All Comer, CCS-PCI, ACS-PCI). The primary endpoint comprised of major adverse cardiac events (MACE), including target lesion revascularization (TLR), target vessel revascularization (TVR), stent thrombosis (ST), and all-cause death. Results: 2118 patients were eligible for further analysis. 1232 patients (58.2%) received a DP-DES. In the all-comer cohort, 5-year MACE rates were 12% for BP-DES vs 14.5% for DP-DES. Multivariate analysis showed no significant difference in MACE for the use of BP-DES (OR 0.941, 95% CI 0.734-1.207, p = 0.631). However, TLR rates were significantly lower in patients treated with BP-DES (3.4% vs 6.8%, OR 0.567, 95% CI 0.372-0.865, p = 0.008), mainly driven by lower rates of TLR within the ACS PCI cohort (1.5% vs 4.9%, OR 0.364, 95% CI 0.158-0.841, p = 0.018). In CCS PCI patients, MACE and TLR rates demonstrated no significant differences. Conclusion: BP-DES and DP-DES show a similar long-term safety profile regarding MACE. BP-DES demonstrate a lower risk of TLR in the all-comer cohort, driven by reduced rates in ACS-PCI patients.
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Skos et al. (2026) conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention (n=2,118). Biodegradable polymer drug-eluting stents (BP-DES) vs. Durable polymer drug-eluting stents (DP-DES) was evaluated on 5-year Major Adverse Cardiac Events (MACE: composite of target lesion revascularization, target vessel revascularization, stent thrombosis, and all-cause death) (OR 0.941, 95% CI 0.734-1.207, p=0.631). Biodegradable polymer drug-eluting stents showed no significant difference in 5-year major adverse cardiac events compared to durable polymer stents.
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