Literature DB >> 23109067

Comparable clinical safety and efficacy of biodegradable versus durable polymer paclitaxel eluting stents despite shorter dual antiplatelet therapy: insights from a multicenter, propensity score-matched registry.

Piotr P Buszman1, Bartlomiej Orlik, Blazej Trela, Krzysztof Milewski, Michal Kozlowski, Maciej Pruski, Janusz Drzewiecki, Athanasios Peppas, Juan F Granada, Greg L Kaluza, Pawel E Buszman.   

Abstract

BACKGROUND: The biodegradable polymer drug-eluting stents have been proposed as an alternative to durable polymer DES, theoretically improving vessel healing and reducing the need for prolonged double anti platelet therapy (DAPT), however clinical significance of this technology is under debate. Therefore, we sought to compare the clinical outcomes of two Paclitaxel eluting stents (PES) containing different polymer-based eluting matrices.
METHODS: In this multicenter registry of 392 consecutive patients who underwent PCI between June 2006 and September 2008, we included patients with stable angina or NSTE-ACS displaying at least one significant lesion (>50% diameter stenosis) in native coronary arteries.
RESULTS: Biodegradable polymer PES (BP-PES, LUC Chopin(2) , Balton, Poland) was implanted in 206 patients, whereas durable polymer PES (DP-PES, Taxus, Boston Scientific, USA) was implanted in 186 patients. There were no significant differences in baseline characteristics between groups with the exception of increased diabetes and number of lesions for BP-PES. In risk-unadjusted analysis at 1-year follow-up, there were no significant differences in TLR (BP-PES: 8.4% vs. DP-PES: 6%; P = 0.36), TVR (BP-PES: 11.1% vs. DP-PES: 8.4%; P = 0.36) and incidence of stent thromboses (BP-PES: 2.15% vs. DP-PES: 3.4%; P = 0.42) between groups. There was also no difference in MACCE between groups (17.6% vs. 14.4%, P = 0.49). The mean dual antiplatelet therapy (DAPT) compliance at 1 year was 77% for BP-PES versus 92% for DP-PES (P = 0.03). Kaplan-Meier analysis showed a significantly higher long-term stroke free survival in BP-PES (P = 0.04). After adjustment, this was sustained with an additional tendency toward higher MI free survival for BP-PES (P = 0.059).
CONCLUSIONS: In this observational analysis, BP-PES were comparable to DP-PES, with regard to incidence of repeated revascularizations, stent thromboses and MACCE despite earlier DAPT discontinuation.
Copyright © 2012 Wiley Periodicals, Inc.

Entities:  

Keywords:  biodegradable polymer; double anti-platelet therapy; durable polymer; paclitaxel eluting stent

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Year:  2012        PMID: 23109067     DOI: 10.1002/ccd.24732

Source DB:  PubMed          Journal:  Catheter Cardiovasc Interv        ISSN: 1522-1946            Impact factor:   2.692


  2 in total

1.  Biodegradable polymer versus second-generation durable polymer drug-eluting stents in patients with coronary artery disease: A meta-analysis.

Authors:  James J Wu; Joshua A H Way; Probal Roy; Andy Yong; Harry Lowe; Leonard Kritharides; David Brieger
Journal:  Health Sci Rep       Date:  2018-10-05

Review 2.  Biodegradable polymer drug-eluting stents versus first-generation durable polymer drug-eluting stents: A systematic review and meta-analysis of 12 randomized controlled trials.

Authors:  Pravesh Kumar Bundhun; Manish Pursun; Feng Huang
Journal:  Medicine (Baltimore)       Date:  2017-11       Impact factor: 1.817

  2 in total

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