Biodegradable Polymer-Coated Thinstrut Sirolimus-Eluting Stent vs. Durable Polymer-Coated Everolimus-Eluting Stent in Diabetic Population

Pawel Gasior Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Silesia, Poland Marek Gierlotka Department of Cardiology, Faculty of Natural Sciences and Technology, University of Opole, Opole, Opolskie, Poland Krzysztof Szczurek-Katanski Scanmed, Scanmed, Cracow, Poland Marcin Osuch Scanmed, Scanmed, Cracow, Poland Magda Roleder Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Silesia, Poland Michal Hawranek 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Silesia, Poland Wojciech Wojakowski Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Silesia, Poland Lech Polonski 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Silesia, Poland

Background: The number of patients with diabetes mellitus (DM) presenting with coronary artery disease is increasing and accounts for more than 30% of patients undergoing percutaneous coronary interventions (PCI). The biodegradable polymer drug-eluting stents were developed to improve vascular healing. We sought to determine the 1-year clinical follow-up in patients with DM treated with the thin strut biodegradable polymer-coated sirolimus-eluting (BP-SES) stent versus durable coating everolimus-elutingstent (DP-EES).

Methods: We analyzed patients with DM treated with either a BP-SES (ALEX™, Balton, Poland, n=670) or DP-EES (XIENCE™, Abbott, USA, n=884) with available 1-year clinical follow-up using propensity-score matching. Outcomes included target vessel revascularization (TVR) as efficacy outcome and all-causedeath, myocardial infarction, and definite/probable stent thrombosis as safety outcomes.

Results: After propensity score matching 527 patients treated with BP-SES and 527 patients treated with DP-EES were selected. Procedural and clinical characteristics were similar between both groups. In-hospital mortality was 3.23% in BP-SES vs. 2.09% in DP-EES group, p=0.25. One-year follow-up demonstrated comparable efficacy outcome TVR (BP-SES 6.64% vs. DP-EES 5.88% p=0.611), as well as similar safety outcomes of all-causedeath (BP-SES 10.06% vs. DP-EES 7.59% p=0.158), myocardial infarction (BP-SES 7.959% vs. 6.83%, p=0.813), anddefinite/probable stent thrombosis (BP-SES 1.14% vs. DP-EES 0.76%, p=0.525).

Conclusions: The thin-strutbiodegradable 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 diabetic patients undergoing PCI.