Key result
Durable-polymer DES shows no benefit over biodegradable-polymer DES for 7-year target lesion failure in advanced CKD.
Why the study?
Does implantation of durable-polymer DES compared with biodegradable-polymer DES reduce 7-year target lesion failure in patients with stage 5 CKD or ESRD undergoing PCI?
Cohort (n=417)
Does implantation of durable-polymer DES compared with biodegradable-polymer DES reduce 7-year target lesion failure in patients with stage 5 CKD or ESRD undergoing PCI?
In patients with stage 5 CKD or ESRD undergoing PCI, 7-year rates of target lesion failure and mortality are high and do not significantly differ between biodegradable-polymer and durable-polymer drug-eluting stents.
Answers are grounded in this paper and cite their sources.
High event rates persist irrespective of DES polymer in advanced CKD/ESRD; leaves open whether randomized trials would detect differences.
OBJECTIVES: Patients with advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD) undergoing percutaneous coronary intervention (PCI) have high event rates, but long-term outcomes after contemporary drug-eluting stent (DES) implantation remain insufficiently defined. This study compared 7-year outcomes between biodegradable polymer DES (BP-DES) and durable polymer DES (DP-DES) in patients with stage 5 CKD or ESRD undergoing PCI. METHODS: We retrospectively analyzed patients with stage 5 CKD or ESRD who underwent PCI with DES implantation between 2010 and 2019. The primary outcome was target lesion failure (TLF), defined as cardiac death, target-vessel myocardial infarction, or clinically driven target lesion revascularization. The secondary outcome was all-cause mortality. Outcomes were compared using Cox regression, competing-risk analysis, and overlap-weighted propensity score analysis. RESULTS: Among 417 patients, the mean age was 66.8 ± 10.4 years, 60.4% were male, and the median follow-up was 80 months. The 84-month cumulative incidence of TLF was 49% with BP-DES and 39% with DP-DES (Gray's test, P = 0.235). The observed 7-year mortality was 37.5 and 32.6%, respectively. DP-DES was not significantly associated with TLF [adjusted hazard ratio vs. BP-DES: 0.79, 95% confidence interval (CI): 0.54-1.14; P = 0.207] or mortality (adjusted hazard ratio: 0.91, 95% CI: 0.63-1.33; P = 0.634). Older age and diabetes mellitus independently predicted mortality. CONCLUSION: In patients with stage 5 CKD or ESRD undergoing PCI, 7-year TLF and mortality were frequent and did not differ significantly by DES polymer type.
No takes yet. Share an insight, caveat, or question.
Yeh et al. (2026) conducted a cohort in Stage 5 chronic kidney disease (CKD) or end-stage renal disease (ESRD) undergoing percutaneous coronary intervention (PCI) (n=417). Durable-polymer drug-eluting stents (DP-DES) vs. Biodegradable-polymer drug-eluting stents (BP-DES) was evaluated on Target lesion failure (TLF), defined as cardiac death, target-vessel myocardial infarction, or clinically driven target lesion revascularization at 84 months (adjusted HR 0.79, 95% CI 0.54-1.14, p=0.207). Durable-polymer DES did not differ from biodegradable-polymer DES for 7-year target lesion failure in advanced CKD/ESRD patients.
Synapse has enriched 10 related papers. Consider them for comparative context: