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Posted by on Oct 12, 2019 in Coronary artery disease | 0 comments

In a nutshell

This study investigated the effects of different drug-eluting stents (DES) in percutaneous coronary intervention (PCI) in patients who have had a heart attack.

They found that biodegradable sirolimus (BS) stents were better than durable polymer everolimus (DPE) stents in improving blood flow. 

Some background

Percutaneous coronary intervention (PCI) is a surgical procedure. PCI is used to restore blood flow after a heart attack (myocardial infaction; MI). A stent is a medical device that is sometimes inserted in the artery during PCI. It helps to keep the blood vessel open. In recent years, new types of stents have been developed. Drug-eluting stents (DES) are one type. These stents release drugs that prevent blood clotting. This reduces the risk of blockages in the artery or around the stent. Sirolimus and everolimus are drugs used to coat stents. 

Other developments include biodegradable and ultrathin stents. These are designed to reduce inflammation and blood vessel injury. Studies suggest that a biodegradable sirolimus (BS) stent is better than a durable polymer everolimus (DPE) stent. One type of MI is called ST-segment elevation MI (STEMI). Patients with STEMI have a higher risk of clots and inflammation than other MI types. It is unclear if the BS stent is better than the DPE stent in patients with STEMI. 

Methods & findings

This study included 1300 patients with STEMI. All patients underwent PCI. Patients were randomly assigned to receive a BS or a DPE stent. The main outcome was target lesion failure (TLF). The parameters that defined TLF included cardiac death, another MI or repeat PCI to remove a blockage. 

After 12 months, TLF occurred in 4% of the BS and 6% of the DPE groups. 

The bottom line

The authors concluded that the BS stent was better than the DPE stent in improving blood flow in patients with STEMI.

The fine print

This study had a short follow-up period. Longer-term studies are needed. This study was funded by Biotronik, the manufacturer of the BS stent.

Published By :

Lancet (London, England)

Date :

Aug 30, 2019

Original Title :

Biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with ST-segment elevation myocardial infarction (BIOSTEMI): a single-blind, prospective, randomised superiority trial.

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