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  3. Long-term outcomes of biodegradable versus durable polymer drug-eluting stents in patients with acute ST-segment elevation myocardial infarction: a pooled analysis of individual patient data from three randomised trials
 

Long-term outcomes of biodegradable versus durable polymer drug-eluting stents in patients with acute ST-segment elevation myocardial infarction: a pooled analysis of individual patient data from three randomised trials

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BORIS DOI
10.7892/boris.48191
Date of Publication
April 22, 2015
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Institut für Sozial- ...

Author
de Waha, Antoinette
King, Lamin A.
Stefanini, Giulio
Universitätsklinik für Kardiologie
Byrne, Robert A.
Serruys, Patrick W.
Meier, Bernhard
Universitätsklinik für Kardiologie
Jüni, Peter
Institut für Sozial- und Präventivmedizin (ISPM)
DKF CTU Bern
Kastrati, Adnan
Windecker, Stephan
Universitätsklinik für Kardiologie
Departement Klinische Forschung, Forschungsgruppe Kardiologie
Subject(s)

600 - Technology::610...

300 - Social sciences...

Series
EuroIntervention
ISSN or ISBN (if monograph)
1774-024X
Publisher
Europa Digital & Publishing
Language
English
PubMed ID
24602961
Description
Aims: Arterial plaque rupture and thrombus characterise ST-elevation myocardial infarction (STEMI) and may aggravate delayed arterial healing following durable polymer drug-eluting stent (DP-DES) implantation. Biodegradable polymer (BP) may improve biocompatibility. We compared long-term outcomes in STEMI patients receiving BP-DES vs. durable polymer sirolimus-eluting stents (DP-SES). Methods and results: We pooled individual patient-level data from three randomised clinical trials (ISAR-TEST-3, ISAR-TEST-4 and LEADERS) comparing outcomes from BP-DES with DP-SES at four years. The primary endpoint (MACE) comprised cardiac death, MI, or target lesion revascularisation (TLR). Secondary endpoints were TLR, cardiac death or MI, and definite or probable stent thrombosis. Of 497 patients with STEMI, 291 received BP-DES and 206 DP-SES. At four years, MACE was significantly reduced following treatment with BP-DES (hazard ratio [HR] 0.59, 95% CI: 0.39-0.90; p=0.01) driven by reduced TLR (HR 0.54, 95% CI: 0.30-0.98; p=0.04). Trends towards reduction were seen for cardiac death or MI (HR 0.63, 95% CI: 0.37-1.05; p=0.07) and definite or probable stent thrombosis (3.6% vs. 7.1%; HR 0.49, 95% CI: 0.22-1.11; p=0.09). Conclusions: In STEMI, BP-DES demonstrated superior clinical outcomes to DP-SES at four years. Trends towards reduced cardiac death or myocardial infarction and reduced stent thrombosis require corroboration in specifically powered trials.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/119007
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deWaha EuroIntervention 2015.pdftextAdobe PDF456.24 KBpublishedOpen
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