Biodegradable-polymer drug-eluting stents demonstrated comparable 1-year clinical outcomes to durable-polymer stents in acute coronary syndrome patients, with no significant difference in target lesion revascularization.
RCT (n=205)
Randomly assigned
No
Does biodegradable-polymer DES reduce MACE compared to durable-polymer DES in patients with NSTEACS undergoing PCI?
Biodegradable-polymer DES represents a safe and effective alternative to durable-polymer DES with comparable 1-year clinical outcomes in patients with NSTEACS undergoing PCI.
Absolute Event Rate: 2% vs 2.86%
p-value: p=0.591
BACKGROUND: Many randomised control studies showed that percutaneous coronary interventions using biodegradable-polymer drug-eluting stents (DES) offer a safe and effective alternative to durable-polymer DES. However, not many studies have discussed its use in the setting of acute coronary syndromes. AIM: We aim to compare the biodegradable-polymer DES with durable-polymer DES when it comes to reducing the incidence of non-ST elevation acute coronary syndrome (NSTEACS) associated with adverse events. METHODS: We enrolled 205 patients presenting with NSTEACS and a TIMI risk score ≥ 3 in this study and divided them into two groups, group A and group B. Biodegradable-polymer DESs were exclusively used in group A, while durable-polymer DESs were used in group B. Major adverse events were reported in both groups during the hospital stay and patients were followed-up for 1 year. RESULTS: In our patients, we intervened on 390 diseased segments in a total of 360 vessels. After intervention, TIMI 0 was achieved in 0.97%, TIMI 1 in 1.46%, TIMI 2 in 2.45%, and TIMI 3 in 95.12% of the treated segments (P-value= 0.677). We implanted 121 biodegradable-polymer DESs and 146 durable-polymer DESs. Clinical success was achieved in 95.12% of our cases. We had 55 patients who needed repeated coronary angiography within 1 year (15 patients treated with biodegradable-polymer DES and 24 patients treated with durable-polymer DES). Eighteen patients experienced angina pains (8 patients treated with biodegradable-polymer DES and 10 patients treated with durable-polymer DES). Only 5 patients needed TLR (2 patients treated with biodegradable-polymer DES and 3 patients treated with durable -polymer DES) (P-value = 0.591), three of them had a myocardial infarction with documented angiographic evidence of significant in-stent restenosis (1 patient treated with biodegradable-polymer DES and 2 patients treated with durable-polymer DESs). CONCLUSION: Biodegradable-polymer DES represents a comparable alternative to durable-polymer DES in the setting of acute coronary syndromes.
Fawzy et al. (Tue,) conducted a rct in Non-ST elevation acute coronary syndrome (NSTEACS) (n=205). Biodegradable-polymer drug-eluting stents vs. Durable-polymer drug-eluting stents was evaluated on Target lesion revascularization (TLR) at 1 year (p=0.591). Biodegradable-polymer drug-eluting stents demonstrated comparable 1-year clinical outcomes to durable-polymer stents in acute coronary syndrome patients, with no significant difference in target lesion revascularization.