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Clinical and angiographic outcomes of bioabsorbable vs. permanent polymer drug-eluting stents in Sweden : a report from the Swedish Coronary and Angioplasty Registry (SCAAR)

Buccheri, Sergio ; James, Stefan ; Lindholm, Daniel ; Fröbert, Ole ; Olivecrona, Göran K. LU ; Persson, Jonas LU ; Hambraeus, Kristina ; Witt, Nils ; Erlinge, David LU and Angerås, Oskar , et al. (2019) In European Heart Journal 40(31). p.2607-2615
Abstract

Aims: Randomized clinical trials have consistently demonstrated the non-inferiority of bioabsorbable polymer drug-eluting stents (BP-DES) with respect to DES having permanent polymers (PP-DES). To date, the comparative performance of BP- and PP-DES in the real world has not been extensively investigated. Methods and results: From October 2011 to June 2016, we analysed the outcomes associated with newer generation DES use in Sweden. After stratification according to the type of DES received at the index procedure, a total of 16 504 and 79 106 stents were included in the BP- and PP-DES groups, respectively. The Kaplan-Meier estimates for restenosis at 2 years were 1.2% and 1.4% in BP- and PP-DES groups, respectively. Definite stent... (More)

Aims: Randomized clinical trials have consistently demonstrated the non-inferiority of bioabsorbable polymer drug-eluting stents (BP-DES) with respect to DES having permanent polymers (PP-DES). To date, the comparative performance of BP- and PP-DES in the real world has not been extensively investigated. Methods and results: From October 2011 to June 2016, we analysed the outcomes associated with newer generation DES use in Sweden. After stratification according to the type of DES received at the index procedure, a total of 16 504 and 79 106 stents were included in the BP- and PP-DES groups, respectively. The Kaplan-Meier estimates for restenosis at 2 years were 1.2% and 1.4% in BP- and PP-DES groups, respectively. Definite stent thrombosis (ST) was low in both groups (0.5% and 0.7% in BP- and PP-DES groups, respectively). The adjusted hazard ratio (HR) for either restenosis or definite ST did not differ between BP- and PP-DES [adjusted HR 0.95, 95% confidence interval (CI) 0.74-1.21; P = 0.670 and adjusted HR 0.79, 95% CI 0.57-1.09; P = 0.151, respectively]. Similarly, there were no differences in the adjusted risk of all-cause death and myocardial infarction (MI) between the two groups (adjusted HR for all-cause death 1.01, 95% CI 0.82-1.25; P = 0.918 and adjusted HR for MI 1.05, 95% CI 0.93-1.19; P = 0.404). Conclusion: In a large, nationwide, and unselected cohort of patients, percutaneous coronary intervention with BP-DES implantation was not associated with an incremental clinical benefit over PP-DES use at 2 years follow-up.

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Contribution to journal
publication status
published
subject
keywords
Bioabsorbable polymer, Clinical outcomes, Drug-eluting stents, Permanent polymer, Stent failure
in
European Heart Journal
volume
40
issue
31
pages
9 pages
publisher
Oxford University Press
external identifiers
  • scopus:85071349781
  • pmid:31079155
ISSN
0195-668X
DOI
10.1093/eurheartj/ehz244
language
English
LU publication?
yes
id
2262ade2-17f8-4f6d-a1ed-388e0698a040
date added to LUP
2019-10-01 13:25:00
date last changed
2020-01-16 04:05:56
@article{2262ade2-17f8-4f6d-a1ed-388e0698a040,
  abstract     = {<p>Aims: Randomized clinical trials have consistently demonstrated the non-inferiority of bioabsorbable polymer drug-eluting stents (BP-DES) with respect to DES having permanent polymers (PP-DES). To date, the comparative performance of BP- and PP-DES in the real world has not been extensively investigated. Methods and results: From October 2011 to June 2016, we analysed the outcomes associated with newer generation DES use in Sweden. After stratification according to the type of DES received at the index procedure, a total of 16 504 and 79 106 stents were included in the BP- and PP-DES groups, respectively. The Kaplan-Meier estimates for restenosis at 2 years were 1.2% and 1.4% in BP- and PP-DES groups, respectively. Definite stent thrombosis (ST) was low in both groups (0.5% and 0.7% in BP- and PP-DES groups, respectively). The adjusted hazard ratio (HR) for either restenosis or definite ST did not differ between BP- and PP-DES [adjusted HR 0.95, 95% confidence interval (CI) 0.74-1.21; P = 0.670 and adjusted HR 0.79, 95% CI 0.57-1.09; P = 0.151, respectively]. Similarly, there were no differences in the adjusted risk of all-cause death and myocardial infarction (MI) between the two groups (adjusted HR for all-cause death 1.01, 95% CI 0.82-1.25; P = 0.918 and adjusted HR for MI 1.05, 95% CI 0.93-1.19; P = 0.404). Conclusion: In a large, nationwide, and unselected cohort of patients, percutaneous coronary intervention with BP-DES implantation was not associated with an incremental clinical benefit over PP-DES use at 2 years follow-up.</p>},
  author       = {Buccheri, Sergio and James, Stefan and Lindholm, Daniel and Fröbert, Ole and Olivecrona, Göran K. and Persson, Jonas and Hambraeus, Kristina and Witt, Nils and Erlinge, David and Angerås, Oskar and Lagerqvist, Bo and Sarno, Giovanna},
  issn         = {0195-668X},
  language     = {eng},
  month        = {08},
  number       = {31},
  pages        = {2607--2615},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal},
  title        = {Clinical and angiographic outcomes of bioabsorbable vs. permanent polymer drug-eluting stents in Sweden : a report from the Swedish Coronary and Angioplasty Registry (SCAAR)},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehz244},
  doi          = {10.1093/eurheartj/ehz244},
  volume       = {40},
  year         = {2019},
}