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Biodegradable polymer stent shows feasibility of earlier DAPT discontinuation
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Patients treated with a biodegradable polymer paclitaxel-eluting stent had similar rates of repeat revascularization, stent thrombosis and MACCE compared with those treated with durable polymer counterparts, despite stopping dual antiplatelet therapy sooner, study results showed.
Researchers conducted a multicenter registry of 392 consecutive patients with stable angina and non-ST elevation ACS, who had at least one significant lesion >50% diameter stenosis and underwent PCI from June 2006 to September 2008. Researchers implanted biodegradable polymer paclitaxel-eluting stents (BP-PES; Luc-Chopin2, Balton) in 206 patients and durable polymer paclitaxel-eluting stents (DP-PES; Taxus Liberte, Boston Scientific) in 186 patients.
In risk unadjusted analysis, there were no significant differences between the biodegradable and durable polymer stents in target lesion revascularization (BP-PES, 8.4% vs. DP-PES, 6%; P=.36), target vessel revascularization (BP-PES, 11.1% vs. DP-PES, 8.4%; P=.36) and stent thromboses (BP-PES, 2.15% vs. DP-PES, 3.4%; P=.42). Rates of MACCE, defined as all-cause death, stroke, TLR and MI, did not differ between the stents (BP-PES, 17.6% vs. DP-PES, 14.4%; P=.49).
DAPT compliance at 1 year was a mean of 77% for biodegradable stents and 92% for durable polymer stents (P=.03). There was a significantly higher long-term stroke-free survival in biodegradable stents (P=.04). After adjustment, this was sustained with an additional tendency toward higher MI-free survival for BP-PES (P=.059).
Biodegradable stents were equivalent to durable polymer stents in terms of outcomes, despite lower compliance to DAPT, the researchers noted.
“A potential clinical benefit, ie, tendency toward lower MI rate and significantly higher stroke-free survival, was noted in patients who received BP-PES,” they wrote. “However, this finding requires cautious interpretation due to the nature of this study and demands further investigation.”
Disclosure: The researchers report no relevant financial disclosures.
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