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

Research output: Contribution to journalArticle

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 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.

Details

Authors
  • Sergio Buccheri
  • Stefan James
  • Daniel Lindholm
  • Ole Fröbert
  • Göran K. Olivecrona
  • Jonas Persson
  • Kristina Hambraeus
  • Nils Witt
  • David Erlinge
  • Oskar Angerås
  • Bo Lagerqvist
  • Giovanna Sarno
Organisations
External organisations
  • Örebro University
  • Danderyd Hospital
  • Falun Central Hospital
  • Karolinska Institutet
  • Sahlgrenska University Hospital
  • Uppsala University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Bioabsorbable polymer, Clinical outcomes, Drug-eluting stents, Permanent polymer, Stent failure
Original languageEnglish
Pages (from-to)2607-2615
Number of pages9
JournalEuropean Heart Journal
Volume40
Issue number31
Publication statusPublished - 2019 Aug 14
Publication categoryResearch
Peer-reviewedYes