Biodegradable polymer drug eluting stents versus durable polymer drug eluting stents for percutaneous coronary intervention – a contemporary retrospective analysis

Objective: We aimed to compare the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with biodegradable polymer drug eluting stents (BD-DES) versus durable polymer drug eluting stents (DP-DES). Methods: Among 11663 PCIs with second generation drug eluting stents preformed in our institution between 2007 and 2019, we identified 8042 procedures performed using DP-DES and 3475 using BD-DES. Propensity score matching was used to create a cohort of well-balanced pairs of patients revascularzied with BD-DES and DP-DES. The primary outcome was the composite of all cause death, Myocardial infarction (MI), target vessel revascularization (TVR) or CABG occurring up to 5 years following procedure. Outcomes were presented with Kaplan-Meier curves and compared with cox adjusted analysis. Results: Mean follow up was 4.8 years, max follow up 12 years. Of 3413 matched pairs 21% were females, and the mean age was 66. Acute cases (MI or ACS) represented 56% of cases. One vessel PCI was performed in ~85%. The composite outcome of all cause death, Myocardial infarction (MI), target vessel revascularization (TVR) or CABG occurred in 5.7 % and 5.2% of patients with DP-DES and BD-DES respectively within 1 year of the index procedure, and in 24.9% and 24.8% within 5 years (p=NS). In a cox analysis adjusting for the age, medication on discharge and history of CABG, Hazard ratio for the composite outcome in the DP-DES versus the BD-DES group was 1.079 (95% CI 0.961-1.212; p=0.198). Conclusions: In this long-term single center propensity score matched cohort PCI’s, we observed no significant difference in the composite of death, re-MI, TVR or CABG between patient treated with DP-DES and BD-DES.