Long-term outcomes after coronary intervention with biodegradable polymer stents in patients with acute coronary syndromes

Manijeh Noori*, Evald Høj Christiansen, Bent Raungaard, Anders Junker, Martin Kirk Christensen, Johnny Kahlert, Michael Maeng, Phillip Freeman, Kirstine Nørregaard Hansen, Christian Juhl Terkelsen, Julia Ellert-Gregersen, Steen Dalby Kristensen, Karsten Tange Veien, Lars Jakobsen, Lisette Okkels Jensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Patients with acute coronary syndromes (ACS) may have worse outcomes after percutaneous coronary intervention compared to patients without ACS. Aims: To compare 5-year efficacy and safety outcomes in patients with and without ACS treated with biodegradable polymers, the ultrathin strut sirolimus-eluting Orsiro stent (O-SES) or the biolimus-eluting Nobori stent (N-BES). Methods: The Scandinavian Organisation for Randomized Trials with Clinical Outcome VII is a randomized trial comparing O-SES and N-BES in an all-comer setting. Of 2525 patients, 1329 (53%) patients had ACS and 1196 (47%) patients were without ACS. Endpoints were target lesion failure (TLF) (a composite of cardiac death, target lesion myocardial infarction, or target lesion revascularization) and definite stent thrombosis within 5 years. Results: At 5-year follow-up, TLF did not differ significantly between patients with and without ACS (12.3% vs. 13.2%; rate ratio (RR) 1.00; 95% confidence interval (CI): 0.70–1.44), whereas the risk of definite stent thrombosis was increased in patients with ACS (2.3% vs. 1.3; RR: 2.01 [95% CI: 1.01–3.98]). In patients with ACS, the rate of TLF was similar between O-SES and N-BES (12.4% vs. 12.3%; RR: 1.02; 95% CI: 0.74–1.40). The reduced risk of definite stent thrombosis in O-SES treated ACS patients within the first year (0.2% vs. 1.6%; RR: 0.12; 95% CI: 0.02–0.93) was not maintained after 5 years (1.8% vs. 2.7%; RR: 0.77; 95% CI: 0.37–1.63). Conclusion: Patients with ACS had an increased risk of stent thrombosis regardless of the stent type used. Long-term outcomes were similar for ACS patients treated with O-SES or N-BES at 5 years.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
Volume103
Issue number2
Pages (from-to)276-285
ISSN1522-1946
DOIs
Publication statusPublished - Feb 2024

Keywords

  • biodegradable polymers
  • biolimus
  • coronary stents
  • myocardial infarction
  • sirolimus
  • stent thrombosis
  • target lesion failure
  • target lesion revascularization
  • Alkanesulfonic Acids
  • Percutaneous Coronary Intervention/adverse effects
  • Humans
  • Risk Factors
  • Drug-Eluting Stents/adverse effects
  • Treatment Outcome
  • Prosthesis Design
  • Absorbable Implants
  • Coronary Artery Disease/diagnostic imaging
  • Coronary Thrombosis/etiology
  • Cardiovascular Agents/adverse effects
  • Stents/adverse effects
  • Acute Coronary Syndrome/diagnostic imaging
  • Polymers

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