Comparing the effectiveness and safety between biodegradable and durable polymer drug-eluting stents in patients with acute coronary syndrome.

This study compared the effectiveness and safety between biodegradable polymer (BP) drug-eluting stents (DES) and durable polymer (DP) DESs in patients with acute coronary syndrome (ACS). The data showed that both stent types demonstrated excellent effectiveness and safety after 1 year. The authors suggested that BP-DES may be more favorable when treating patients with ACS as there was a slight increase in the risks of death or heart attacks in the DP-DES group after 2 years.

Acute coronary syndrome (ACS) is caused by sudden, reduced blood flow to the heart. ACS can result in major adverse cardiac events (MACEs) such as heart attacks or strokes which can lead to death. Restoring blood flow is important for treating ACS. In some cases, a stent is implanted. A stent is a flexible tube that keeps the artery open. Drug-eluting stents (DES) also release medication into the body. These drugs prevent cells from gathering inside the stent and blocking it again.

DES can have a durable polymer (DP) coating that emits the drug. However, these stents have been associated with an increased risk of stent failure. This was thought to be because of sensitivity to the polymer material. Another type of DES involves a stent that dissolves after 6 months coated with an inorganic coating loaded with a drug. This is called bio-degradable (BP) DES. The effectiveness and safety of BP-DES compared to DP-DES in patients with ACS are still unknown.

This study analyzed 8 studies and involved 8089 patients with ACS. 3898 patients were treated with BP-DES. 4191 patients were treated with DP-DES.

After 1 year, the risks of MACEs, target vessel revascularization (TVR; restoring blood flow in a target blood vessel), target lesion revascularization (TLR; restoring blood in the region of the blood vessel where a plaque lesion reduced its capacity), and stent thrombosis (ST; blockage of the stent) were similar between the 2 groups.

After 2 years, BP-DES significantly reduced the risk of MACEs by 29%, TLR by 29%, TVR by 30%, and ST by 37% compared to DP-DES.

This study concluded that both stent types demonstrated excellent effectiveness and safety after 1 year. The authors suggested that BP-DES may be more favorable when treating patients with ACS as there was a slight increase in the risks of death and heart attacks in the DP-DES group after 2 years.

The studies analyzed had differences in the type of BP-DES used and in the duration of dual antiplatelet therapy which may influence clinical outcomes.