Safety and Efficacy of Bioresorbable Biodegradable Polymer-Coated Thin Strut Sirolimus-Eluting Stent vs. Durable Polymer-Coated Everolimus-Eluting Stent in Patients with Acute Myocardial Infarction

Introduction: The biodegradable polymer drug-eluting stents were developed to improve vascular healing. However, further data is needed to confirm the safety and efficacy of these stents in patients with acute myocardial infarction (AMI).

Aim: We sought to determine the 1-year clinical follow-up in patients with AMI treated with the thin strut biodegradable polymer-coated sirolimus-eluting (BP-SES) stent versus durable coating everolimus-eluting stent (DP-EES).

Material and Methods: We analyzed patients with AMI (STEMI and NSTEMI) treated with either a BP-SES (ALEX™, Balton, Poland, n=886) or DP-EES (XIENCE™, Abbott, USA, n=1054) with available 1-year clinical follow-up using propensity-score matching. Outcomes included target vessel revascularization (TVR) as efficacy outcome and all-cause death, myocardial infarction, and definite/probable stent thrombosis as safety outcomes.

Results: After propensity score matching 672 patients treated with BP-SES and 672 patients treated with DP-EES were selected. Procedural and clinical characteristics were similar between both groups. In-hospital mortality was similar in both tested groups. One-year follow-up demonstrated comparable efficacy outcome TVR (BP-SES 7.1% vs. DP-EES 5.2% p=0.14), as well as similar safety outcomes of all-cause death, myocardial infarction, and definite/probable stent thrombosis.

Conclusions: The thin-strut biodegradable polymer coated sirolimus-eluting stent demonstrated comparable clinical outcomes at 1-year after implantation to the DP-EES. These data support the relative safety and efficacy of BP-SES in AMI patients undergoing PCI.