Abstract Background The advent of drug-eluting stents (DES) has significantly reduced the rates of repeat revascularization compared to bare-metal stents (BMS). Durable polymer coating used in durable polymer (DP)- DES for sustained drug delivery may cause local inflammation due to residual polymer. Biodegradable polymer (BP)-DES has been introduced with the potential advantage of eliminating polymer residue over time, but its clinical outcomes compared to DP-DES remain uncertain. Purpose This retrospective study compared target vessel revascularization rates between BP-DES and DP-DES treated lesions to evaluate whether BP-DES reduces revascularization events potentially linked to polymer-related inflammation. Methods All lesions treated with either DP-DES or BP-DES at a single institution were included in this study. Propensity score matching was performed to minimize selection bias, using variables including age, sex, creatinine clearance, hypertension, diabetes, dyslipidemia, and acute coronary syndrome. The primary endpoint was target vessel revascularization (TVR) at 3-year follow-up. Results From January 2003 to December 2021, a total of 19,743 lesions were included in the study. After PSM, 5,660 lesions treated with DP-DES were matched with 5,660 lesions treated with BP-DES. TVR occurred in 178 lesions (3.1%) treated with DP-DES and in 98 patients (1.7%) treated with BP-DES (hazard ratio 0.56; 95% confidence interval: 0.47-0.66; p0.001). Conclusions In this retrospective study, lesions treated with BP-DES showed significantly lower rates of target vessel revascularization (TVR) at 3 years compared to those treated with DP-DES. It suggested that BP-DES may provide a clinical advantage in reducing revascularization events, potentially due to the absence of polymer-related inflammation. Further randomized controlled studies are warranted to confirm these results and evaluate long-term outcomes associated with BP-DES.Figure 1 Figure 2
Lee et al. (Sat,) studied this question.