# Outcomes of durable versus biodegradable polymer drug-eluting stents in patients with coronary artery disease

## TL;DR

This study compares biodegradable and durable polymer drug-eluting stents in heart disease patients, finding similar safety but fewer repeat procedures with biodegradable ones.

## Contribution

The study provides new evidence on the comparative safety and effectiveness of biodegradable versus durable polymer drug-eluting stents in coronary artery disease patients.

## Key findings

- Biodegradable polymer DES showed similar 5-year MACE rates compared to durable polymer DES.
- TLR rates were significantly lower with biodegradable polymer DES, especially in ACS-PCI patients.
- No significant differences in MACE or TLR were observed in CCS PCI patients.

## Abstract

Percutaneous coronary intervention (PCI) is among the most common cardiovascular procedures, but stents still pose risks of restenosis or thrombosis. Drug-eluting stents (DES) with polymer coatings have improved long-term outcomes.

This study evaluated whether the latest biodegradable polymer DES (BP-DES) offer improved safety over durable polymer DES (DP-DES).

Data were collected from a single-centre registry at the Medical University of Vienna, including patients who underwent PCI between 2015 and 2020. Patients were categorized by stent type and PCI indication (All Comer, CCS-PCI, ACS-PCI). The primary endpoint comprised of major adverse cardiac events (MACE), including target lesion revascularization (TLR), target vessel revascularization (TVR), stent thrombosis (ST), and all-cause death.

2118 patients were eligible for further analysis. 1232 patients (58.2%) received a DP-DES. In the all-comer cohort, 5-year MACE rates were 12% for BP-DES vs 14.5% for DP-DES. Multivariate analysis showed no significant difference in MACE for the use of BP-DES (OR 0.941, 95% CI 0.734–1.207, p = 0.631). However, TLR rates were significantly lower in patients treated with BP-DES (3.4% vs 6.8%, OR 0.567, 95% CI 0.372–0.865, p = 0.008), mainly driven by lower rates of TLR within the ACS PCI cohort (1.5% vs 4.9%, OR 0.364, 95% CI 0.158–0.841, p = 0.018). In CCS PCI patients, MACE and TLR rates demonstrated no significant differences.

BP-DES and DP-DES show a similar long-term safety profile regarding MACE. BP-DES demonstrate a lower risk of TLR in the all-comer cohort, driven by reduced rates in ACS-PCI patients.