首页 | 本学科首页   官方微博 | 高级检索  
检索        


Long-term outcomes of biodegradable polymer versus durable polymer drug-eluting stents in patients with diabetes a pooled analysis of individual patient data from 3 randomized trials
Authors:Antoinette de Waha  Giulio G Stefanini  Lamin A King  Robert A Byrne  Patrick W Serruys  Sebastian Kufner  Bernhard Meier  Peter Jüni  Adnan Kastrati  Stephan Windecker
Institution:1. Deutsches Herzzentrum, Technische Universität, Munich, Germany;2. Department of Cardiology, Bern University Hospital, Bern, Switzerland;3. Thoraxcenter, Erasmus University, Rotterdam, Netherlands;4. Clinical Trials Unit, Bern University Hospital, Bern, Switzerland
Abstract:

Background

There is ongoing debate on the optimal drug-eluting stent (DES) in diabetic patients with coronary artery disease. Biodegradable polymer drug-eluting stents (BP-DES) may potentially improve clinical outcomes in these high-risk patients. We sought to compare long-term outcomes in patients with diabetes treated with biodegradable polymer DES vs. durable polymer sirolimus-eluting stents (SES).

Methods

We pooled individual patient-level data from 3 randomized clinical trials (ISAR-TEST 3, ISAR-TEST 4 and LEADERS) comparing biodegradable polymer DES with durable polymer SES. Clinical outcomes out to 4 years were assessed. The primary end point was the composite of cardiac death, myocardial infarction and target-lesion revascularization. Secondary end points were target lesion revascularization and definite or probable stent thrombosis.

Results

Of 1094 patients with diabetes included in the present analysis, 657 received biodegradable polymer DES and 437 durable polymer SES. At 4 years, the incidence of the primary end point was similar with BP-DES versus SES (hazard ratio = 0.95, 95% CI = 0.74–1.21, P = 0.67). Target lesion revascularization was also comparable between the groups (hazard ratio = 0.89, 95% CI = 0.65–1.22, P = 0.47). Definite or probable stent thrombosis was significantly reduced among patients treated with BP-DES (hazard ratio = 0.52, 95% CI = 0.28–0.96, P = 0.04), a difference driven by significantly lower stent thrombosis rates with BP-DES between 1 and 4 years (hazard ratio = 0.15, 95% CI = 0.03–0.70, P = 0.02).

Conclusions

In patients with diabetes, biodegradable polymer DES, compared to durable polymer SES, were associated with comparable overall clinical outcomes during follow-up to 4 years. Rates of stent thrombosis were significantly lower with BP-DES.
Keywords:Biodegradable polymer  Biolimus A9  Diabetes mellitus  Drug-eluting stent  Stent thrombosis  Meta-analysis
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号