The relation of polymer structure of stent used in patients with acute coronary syndrome revascularized by stent implantation with long‐term cardiovascular events

Author:

Yaylak Barış1ORCID,Polat Fuat1ORCID,Onuk Tolga1ORCID,Akyüz Şükrü2ORCID,Çalık Ali Nazmi1ORCID,Çetin Mustafa3ORCID,Eren Semih1ORCID,Mollaalioğlu Feyza1ORCID,Kolak Zeynep1ORCID,Durak Furkan4ORCID,Dayı Şennur Ünal1ORCID

Affiliation:

1. Department of Cardiology Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Educatıon Research Hospıtal İstanbul Türkiye

2. Department of Cardiology Okan University Faculty of Medicine İstanbul Türkiye

3. Department of Cardiology Recep Tayyip Erdoğan University Rize Türkiye

4. Department of Cardiology Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital İstanbul Türkiye

Abstract

AbstractIntroductionDrug‐eluting stents (DES) have revolutionized percutaneous coronary intervention (PCI) by improving event‐free survival compared to older stent designs. However, early‐generation DES with polymer matrixes have raised concerns regarding late stent thrombosis due to delayed vascular healing. To address these issues, biologically bioabsorbable polymer drug‐eluting stents (BP‐DES) and polymer‐free drug‐eluting stents (PF‐DES) have been developed.AimThe aim of the present study is to evaluate and compare the long‐term effects of different stent platforms in patients with acute coronary syndrome (ACS) undergoing PCI.Material and MethodsWe conducted a retrospective, observational study involving 1192 ACS patients who underwent urgent PCI. Patients were treated with thin‐ strut DP‐DES, ultra‐thin strut BP‐DES, or thin‐strut PF‐DES. The primary endpoint was a composite of cardiac death, target vessel myocardial infarction (TVMI), and clinically driven target lesion revascularization (CITLR) at 12 months and 4 years.ResultsThe baseline demographics and clinical characteristics of patients in the three stent subgroups were similar. No significant differences were observed in target lesion failure (TLF), cardiac mortality, TVMI, and stent thrombosis (ST) rates among the three subgroups at both 12 months and 4 years. However, beyond the first year, the rate of CITLR was significantly lower in the ultra‐thin strut BP‐DES subgroup compared to thin‐strut DP‐DES, suggesting potential long‐term advantages of ultra‐thin strut BP‐DES. Additionally, both ultra‐thin strut BP‐DES and thin‐strut PF‐DES demonstrated lower ST rates after the first year compared to thin‐strut DP‐DES.ConclusionOur study highlights the potential advantages of ultra‐thin strut BP‐DES in reducing CITLR rates in the long term, and both ultra‐thin strut BP‐DES and thin‐strut PF‐DES demonstrate lower rates of ST beyond the first year compared to thin‐strut DP‐DES. However, no significant differences were observed in overall TLF, cardiac mortality and TVMI rates among the three stent subgroups at both 12 months and 4 years.

Publisher

Wiley

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine

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