Biodegradable polymer limus-eluting stents are noninferior to permanent polymer-based stents: the ISAR-TEST-4 trial

Biodegradable polymer drug-eluting stent (DES) platforms have the potential to enhance long-term clinical outcomes following coronary stenting. The concept of controlled drug elution by means of a polymer that, subsequent to serving its useful function, degrades to inert monomers is inherently attractive, although data concerning their efficacy are limited to date. In the Intracoronary Stenting and Angiographic Restenosis Test Efficacy of 3 Limus-Eluting Stents (ISAR-TEST)-4 study, we hypothesized that at 12 months, clinical safety and efficacy with a biodegradable polymer DES would be noninferior to that of permanent polymer DES. Patients were randomly assigned to treatment with biodegradable polymer DES (sirolimus-eluting; n = 1299) or permanent polymer DES (n = 1304; sirolimus-eluting, Cypher, n = 652; or everolimus-eluting, Xience-V, n = 652). The primary end point was a composite of cardiac death, myocardial infarction related to the target vessel or revascularisation related to the target lesion. Th...