What question did this study set out to answer?

To compare the long-term clinical efficacy and safety of ultrathin strut biodegradable polymer drug-eluting stents against durable polymer stents in STEMI patients undergoing primary percutaneous coronary intervention.

December 15, 2021Journal of Clinical MedicineOpen Access

Real-World Long-Term Clinical Outcomes of Ultrathin Strut Biodegradable Polymer Drug-Eluting Stents in Korean ST-Segment-Elevation Myocardial Infarction (STEMI) Patients with or without Acute Heart Failure Undergoing Primary Percutaneous Coronary Intervention

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Why the study?

Biodegradable polymers and ultrathin struts were recently introduced to drug-eluting stents to improve outcomes, but their performance compared with conventional durable polymer stents in STEMI undergoing primary PCI required evaluation.

Does ultrathin strut biodegradable polymer drug-eluting stents reduce target lesion failure compared to conventional durable polymer drug-eluting stents in Korean STEMI patients undergoing primary PCI?

Population

356 Korean STEMI patients undergoing primary PCI

Comparison

UBDP-DES vs conventional DP-DES

Design

Propensity score-matched observational study

Follow-up

Median 63.8 months

Authors

AJAlbert Youngwoo JangGachon University JYJongwook YuYonsei University POPyung Chun OhGachon University

Discussion

Member takes

Implication

Similar TLF rates with UBDP-DES versus DP-DES after matching; observational data leave open any superiority in STEMI PPCI.

Key Points

To compare the long-term clinical efficacy and safety of ultrathin strut biodegradable polymer drug-eluting stents against durable polymer stents in STEMI patients undergoing primary percutaneous coronary intervention.
Analyzed 356 Korean STEMI patients undergoing primary percutaneous coronary intervention (n = 160 receiving UBDP-DES and n = 196 receiving DP-DES) with a median follow-up of 63.8 months.
Applied propensity score matching to balance baseline risk profiles, creating 116 matched patient pairs to evaluate target lesion failure, defined as cardiac death, target vessel myocardial infarction, or target lesion revascularization.
Prior to matching, target lesion failure occurred in 8.1% of the UBDP-DES group versus 4.1% of the DP-DES group (HR 2.14, 95% CI 0.89–5.18, p = 0.091).
After propensity score matching, target lesion failure rates were identical between groups at 5.3% versus 5.3% (HR 1.04, 95% CI 0.34–3.22, p = 0.947).
Initial acute heart failure (Killip class ≥ 3) carried a 13.6% 30-day mortality rate, with heart failure patients experiencing numerically higher target lesion failure when treated with UBDP-DES.

Structured PICO

Population

356 Korean ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI), mean age 60.3 ± 12.7 years, 81.7% male.

Intervention

Ultrathin strut biodegradable polymer drug-eluting stents (UBDP-DES)

Comparator

Conventional durable polymer drug-eluting stents (DP-DES)

Outcome

Target lesion failure (TLF), including cardiac death, target vessel myocardial infarction, and ischemic-driven target lesion revascularization (ID-TLR)composite

Ultrathin strut biodegradable polymer drug-eluting stents showed similar long-term clinical outcomes to conventional durable polymer stents in real-world STEMI patients undergoing primary PCI.

Cite This Study

Jang et al. (2021) studied this question.

synapsesocial.com/papers/6a90a32d439f656a744c5fb2 https://doi.org/10.3390/jcm10245898

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Real-World Long-Term Clinical Outcomes of Ultrathin Strut Biodegradable Polymer Drug-Eluting Stents in Korean ST-Segment-Elevation Myocardial Infarction (STEMI) Patients with or without Acute Heart Failure Undergoing Primary Percutaneous Coronary Intervention

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Real-World Long-Term Clinical Outcomes of Ultrathin Strut Biodegradable Polymer Drug-Eluting Stents in Korean ST-Segment-Elevation Myocardial Infarction (STEMI) Patients with or without Acute Heart Failure Undergoing Primary Percutaneous Coronary Intervention

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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