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  • Improved clinical outcome with biodegradable polymer drug-eluting stents compared to durable polymer drug-eluting stents for primary percutaneous coronary intervention

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Original research
Improved clinical outcome with biodegradable polymer drug-eluting stents compared to durable polymer drug-eluting stents for primary percutaneous coronary intervention
  1. Ratna Andriyati1,
  2. Doni Firman1,
  3. Yovi Kurniawati1,
  4. Amir Aziz Alkatiri1,
  5. Raymond Pranata2,
  6. Hary Sakti Muliawan1,
  7. Vienna Rossimarina1,
  8. Sunarya Soerianata1
  1. 1 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  2. 2 Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
  1. Correspondence to Doni Firman, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jl. Letjen S. Parman Kav 87, Slipi, Jakarta Barat 11420, Indonesia; dr.donifirman{at}gmail.com

Abstract

Background Studies comparing the clinical outcomes of second-generation biodegradable polymer drug-eluting stents (BP-DES) and second-generation durable polymer drug-eluting stents (DP-DES) in patients with ST-segment elevation myocardial infarction (STEMI) with follow-up duration of more than 1 year are still limited.

Objective This study aimed to compare the 2-year clinical outcome of BP-DES with second-generation DP-DES in patients undergoing primary percutaneous coronary intervention (PPCI).

Methods This is a retrospective cohort study in patients with STEMI, the primary endpoint was major adverse cardiac events (MACE) defined as recurrent myocardial infarction, total repeat revascularisation and cardiac death. The secondary endpoint was stent thrombosis (ST) defined as definite, probable or possible.

Results A total of 400 patients were analysed (197 BP-DES groups and 203 DP-DES groups). BP-DES were independently associated with lower incidence of MACE (adjusted HR 0.67, 95% CI 0.21 to 0.91, p=0.005) and ST (adjusted HR 0.62, 95% CI 0.19 to 0.73, p<0.016) within 2 years of follow-up. Subgroup analysis of MACE individual components showed that BP-DES were associated with lower cardiac deaths (HR 0.35; 95% CI 0.18 to 0.94; p<0.001) compared to DP-DES, but not recurrent myocardial infarction and total repeat revascularisation.

Conclusions BP-DES were associated with better clinical outcomes compared to second-generation DP-DES in patients with STEMI undergoing PPCI.

  • Cardiology
  • adult cardiology
  • coronary heart disease
  • coronary intervention
  • ischaemic heart disease
  • myocardial infarction

http://dx.doi.org/10.1136/postgradmedj-2020-138243

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    Footnotes

    • Contributors RA and DF are involved in the conceptualisation and design of the study. Data curation was performed by RA. RA, YK and AAA wrote the manuscript draft. RP, HSM, VR and SS reviewed, edited and provided critical revision to the manuscript. All authors performed extensive research on the topic and contributed to the writing of the manuscript. All authors approved the final form of the manuscript. RA performed the statistical analysis.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was performed in compliance with the guidelines for good clinical practice and the Declaration of Helsinki and was approved by the institutional ethical review board of National Cardiovascular Center Harapan Kita, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia (LB.02.01/VII/382/KEP.052/2019).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The datasets generated during and/or analysed during the current study are available from the corresponding author (DF) on reasonable request.