AUTHOR=Lee Seung-Jun , Choi Dong-Woo , Suh Yongsung , Hong Sung-Jin , Ahn Chul-Min , Kim Jung-Sun , Kim Byeong-Keuk , Ko Young-Guk , Choi Donghoon , Park Eun-Cheol , Jang Yangsoo , Nam Chung-Mo , Hong Myeong-Ki 

TITLE=Long-Term Clinical Outcomes Between Biodegradable and Durable Polymer Drug-Eluting Stents: A Nationwide Cohort Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.873114

DOI=10.3389/fcvm.2022.873114

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Despite the theoretical benefits of biodegradable polymer drug-eluting stents (BP-DES), clinical benefits of BP-DES over durable polymer DES (DP-DES) have not been clearly demonstrated. Using data from a large-volume nationwide cohort, we compared long-term clinical outcomes between BP-DES- and DP-DES-treated patients.</p></sec><sec><title>Methods</title><p>A retrospective cohort study that enrolled all patients who underwent percutaneous coronary intervention (PCI) with new-generation DES between 2010 and 2016 in Korea was conducted by using the National Health Insurance Service database. The outcomes of interest were all-cause death, cardiovascular death, and myocardial infarction (MI).</p></sec><sec><title>Results</title><p>A total of 127,731 patients treated with new-generation DES with thin struts (&lt;90 μm) were enrolled for this analysis. After stabilized inverse probability of treatment weighting, the incidence of all-cause death was significantly lower in patients treated with BP-DES (<italic>n</italic> = 19,521) at 5 years after PCI (11.3 vs. 13.0% in those treated with DP-DES [<italic>n</italic> = 108,067], hazard ratio [HR] 0.92, 95% confidence interval [CI], 0.88–0.96, <italic>p</italic> &lt; 0.001), while showing no statistically significant difference at 2 years after PCI (5.7 vs. 6.0%, respectively, HR 0.95, 95% CI, 0.89–1.01, <italic>p</italic> = 0.238). Similarly, use of BP-DES was associated with a lower incidence of cardiovascular death (7.4 vs. 9.6% in those treated with DP-DES, HR 0.82, 95% CI, 0.77–0.87, <italic>p</italic> &lt; 0.001), and MI (7.4 vs. 8.7%, respectively, HR 0.90, 95% CI, 0.86–0.94, <italic>p</italic> = 0.006) at 5 years after PCI. There was no statistically significant difference of cardiovascular death (4.6 vs. 4.9%, respectively, HR 0.93, 95% CI, 0.85–1.01, <italic>p</italic> = 0.120) and MI (5.0 vs. 5.1%, respectively, HR 0.98, 95% CI, 0.92–1.05, <italic>p</italic> = 0.461) at 2 years after PCI.</p></sec><sec><title>Conclusions</title><p>Implantation of BP-DES was associated with a lower risk of all-cause death, cardiovascular death, and MI compared with DP-DES implantation. This difference was clearly apparent at 5 years after DES implantation.</p></sec><sec><title>Clinical Trial Registration</title><p><ext-link ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov/" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrial.gov</ext-link>, NCT04715594.</p></sec>