Biodegradable Polymer vs. Durable Polymer Drug Eluting Stents in STEMI Patients Undergoing Primary PCI

Introduction

Biodegradable polymer drug eluting stents (BP-DES) are widely used for the treatment of patients with coronary artery disease in multiple clinical scenarios. Whether, BP-DES offer a clinical advantage over durable polymer DES (DP-DES) in patients with ST elevation myocardial infarction (STEMI) is unknown. We aim to compare the outcomes of STEMI patients treated with primary PCI with either BP-DES or DP-DES.

Methods and results

In this retrospective, single center study; STEMI patients arriving at our institution within 12 hours of symptoms were compared according to type of DES used. Patients treated with a DP-DES (N=328) had similar baseline characteristics than those treated using a BP-DES (N=141) (table). In comparison to DP-DES patients treated with a BP-DES had lower rates of anterior wall STEMI and higher rates of RV infarction [72 (51) vs. 207 (63) and 16 (11.3) vs. 18 (5.5) for anterior wall STEMI and RV infarction in patients treated with BP-DES vs. DP DES; respectively (p=0.04)]. At one month, one-year and 2 years follow-up, rates of death, myocardial infarction (MI), target vessel revascularization (TVR), stent-thrombosis (ST) and major acute cardiovascular events (MACE) were similar within the groups. All-cause death, MI, TVR, ST and MACE at one year follow up were 2.4% vs. 0.7, p 0.2; 0.8% vs. 1.4%, p=0.6; 2.4% vs. 1.4%, p=0.5; 0.6% vs. 0.7% p=0.9 and 6.1% vs. 5.7%, p=0.9, for patients treated with a DP-DES vs. BP-DES; respectively.

Conclusion

Biodegradable polymer DES has similar efficacy and safety profiles at 2 years compared with durable polymer DES in STEMI patients treated with primary PCI.