Thin Strut CoCr biodegradable polymer biolimus A9-eluting stents versus thicker strut stainless steel biodegradable polymer Biolimus A9-eluting stents: Two-year clinical outcomes
Authors
Menown, IBAMamas, MA
Cotton, JM
Hildick-Smith, D
Eberli, FR
Leibundgut, G
Tresukosol, D
MacAya, C
Copt, S
Slama, SS
Oldroyd, KG
Issue Date
2021-04-01
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Background. While thinner struts are associated with improved clinical outcomes in bare-metal stents (BMS), reducing strut thickness may affect drug delivery from drug-eluting stents (DES) and there are limited data comparing otherwise similar thin and thick strut DES. We assessed 2-year outcomes of patients treated with a thin strut (84-88um) cobalt-chromium, biodegradable polymer, Biolimus A9-eluting stent (CoCr-BP-BES) and compared these to patients treated with a stainless steel, biodegradable polymer, Biolimus A9-eluting stent (SS-BP-BES). Methods. In total, 1257 patients were studied: 400 patients from 12 centres receiving ≥1 CoCr-BP-BES in the prospective Biomatrix Alpha registry underwent prespecified comparison with 857 patients who received ≥1 Biomatrix Flex SS-BP-BES in the LEADERS study (historical control). The primary outcome was major adverse cardiac events (MACE)-cardiac death, myocardial infarction (MI), or clinically driven target vessel revascularization (cd-TVR). Propensity analysis was used to adjust for differences in baseline variables and a landmark analysis at day-3 to account for differences in periprocedural MI definitions. Results. MACE at 2 years occurred in 6.65% CoCr-BP-BES versus 13.23% SS-BP-BES groups (unadjusted HR 0.48 [0.31-0.73]; P = 0.0005). Following propensity analysis, 2-year adjusted MACE rates were 7.4% versus 13.3% (HR 0.53 [0.35-0.79]; P = 0.004). Definite or probable stent thrombosis, adjudicated using identical criteria in both studies, occurred less frequently with CoCr-BP-BES (1.12% vs. 3.22%; adjusted HR 0.32 [0.11-0.9]; P = 0.034). In day-3 landmark analysis, the difference in 2-year MACE was no longer significant but there was a lower patient-orientated composite endpoint (11.7% vs. 18.4%; HR 0.6 [0.43-0.83]; P = 0.006) and a trend to lower target vessel failure (5.8% vs. 9.1%; HR 0.63 [0.4-1.00]; P = 0.078). Conclusion. At 2-year follow-up, propensity-adjusted analysis showed the thin strut (84-88um) Biomatrix Alpha CoCr-BP-BES was associated with improved clinical outcomes compared with the thicker strut (114-120um) Biomatrix Flex SSBP- BES.Citation
Menown, I.B.A., Mamas, M.A., Cotton, J.M. et al. (2021) Thin Strut CoCr biodegradable polymer biolimus A9-eluting stents versus thicker strut stainless steel biodegradable polymer Biolimus A9-eluting stents: Two-year clinical outcomes. Journal of Interventional Cardiology, Article ID 6654515, https://doi.org/10.1155/2021/6654515Publisher
HindawiJournal
Journal of Interventional CardiologyPubMed ID
33880087 (pubmed)Additional Links
https://www.hindawi.com/journals/jitc/2021/6654515/Type
Journal articleLanguage
enDescription
© 2021 The Authors. Published by Hindawi. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1155/2021/6654515ISSN
0896-4327EISSN
1540-8183ae974a485f413a2113503eed53cd6c53
10.1155/2021/6654515
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Except where otherwise noted, this item's license is described as Licence for published version: Creative Commons Attribution 4.0 International
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