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KMID : 0368120190490010069
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Korean Circulation Journal
2019 Volume.49 No. 1 p.69 ~ p.80
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Safety and Efficacy of Biodegradable Polymer-biolimus-eluting Stents (BP-BES) Compared with Durable Polymer-everolimus-eluting Stents (DP-EES) in Patients Undergoing Complex Percutaneous Coronary Intervention
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Song Pil-Sang
Park Kyu-Tae
Kim Min-Jeong
Jeon Ki-Hyun
Park Jin-Sik
Choi Rak-Kyeong
Song Young-Bin
Choi Seung-Hyuk
Choi Jin-Ho
Lee Sang-Hoon
Gwon Hyeon-Cheol
Jeong Jin-Ok
Im Eul-Soon
Kim Sang-Wook
Chun Woo-Jung
Oh Ju-Hyeon
Hahn Joo-Yong
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Abstract
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Background and Objectives: There are no data comparing clinical outcomes of complex percutaneous coronary intervention (PCI) between biodegradable polymer-biolimus-eluting stents (BP-BES) and durable polymer-everolimus-eluting stents (DP-EES). We sought to evaluate the safety and efficacy of BP-BES compared with DP-EES in patients undergoing complex PCI.
Methods: Patients enrolled in the SMART-DESK registry were stratified into 2 categories based on the complexity of PCI. Complex PCI was defined as having at least one of the following features: unprotected left main lesion, ≥2 lesions treated, total stent length >40 mm, minimal stent diameter ≤2.5 mm, or bifurcation as target lesion. The primary outcome was target lesion failure (TLF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TV-MI), or target lesion revascularization (TLR) at 2 years of follow-up.
Results: Of 1,999 patients, 1,145 (57.3%) underwent complex PCI: 521 patients were treated with BP-BES and 624 with DP-EES. In propensity-score matching analysis (481 pairs), the risks of TLF (3.8% vs. 5.2%, adjusted hazard ratio [HR], 0.578; 95% confidence interval [CI], 0.246?1.359; p=0.209), cardiac death (2.5% vs. 2.5%, adjusted HR, 0.787; 95% CI, 0.244?2.539; p=0.689), TV-MI (0.5% vs. 0.4%, adjusted HR, 1.128; 95% CI, 0.157?8.093; p=0.905), and TLR (1.1% vs. 2.9%, adjusted HR, 0.390; 95% CI, 0.139?1.095; p=0.074) did not differ between 2 stent groups after complex PCI.
Conclusions: Clinical outcomes of BP-BES were comparable to those of DP-EES at 2 years after complex PCI. Our data suggest that use of BP-BES is acceptable, even for complex PCI.
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KEYWORD
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Coronary artery disease, Percutaneous coronary intervention, Drug-eluting stents
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