In a nutshell
This study was carried out to compare long-term outcomes between polymer-free (PF) stents and durable polymer (DP) drug-eluting stents (DES) in patients with coronary artery disease (CAD). The study found that at 10 years both DES types had similar outcomes.
Some background
CAD involves blockages in arteries supplying the heart. This can lead to pain (angina), heart attacks, or death. DES are little tubes that are inserted into blocked vessels to restore blood flow to the heart. They have a coating that slowly releases a drug that keeps the blockage from reappearing.
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 metal stent coated with an inorganic coating loaded with a drug. This is called polymer-free (PF) DES. Previous studies have shown similar effectiveness between the 2 types of DES at 12 months. However, the long-term outcomes of PF-DES compared to DP-DES are still laking.
Methods & findings
A total of 3002 patients were enrolled in this trial. 2002 patients had received a PF-DES. 1000 patients received a DP-DES. Patients were evaluated for an average of 10.3 years. The main outcome was stent failure. This was evaluated by the rate of heart attacks due to blockage in the target blood vessel, new blockage of the target blood vessel, or death due to failure of the stent.
The rate of stent failure after 10 years was similar between the PF-DES and DP-DES groups (43.8% vs. 43%). There was no difference between the 2 types of stents regarding cardiovascular death, heart attack, or CAD in general. The rate of a blockage of the stent (stent thrombosis) was also similar between the PF-DES and the DP-DES groups (1.6% vs 1.9%).
The bottom line
The authors concluded that PF-DES and DP-DES had similar long-term outcomes in patients with CAD.
The fine print
Some patients were lost to follow-up. This might influence the results.
Published By :
Journal of the American College of Cardiology
Date :
Jul 14, 2020
