Long‐term outcomes after coronary intervention with biodegradable polymer stents in patients with acute coronary syndromes

Author:

Noori Manijeh1ORCID,Christiansen Evald Høj2,Raungaard Bent3,Junker Anders1,Christensen Martin Kirk3,Kahlert Johnny4,Maeng Michael2,Freeman Phillip3,Hansen Kirstine Nørregaard1,Terkelsen Christian Juhl2,Ellert‐Gregersen Julia1,Kristensen Steen Dalby2,Veien Karsten Tange1,Jakobsen Lars2,Jensen Lisette Okkels1

Affiliation:

1. Department of Cardiology Odense University Hospital Odense Denmark

2. Department of Cardiology Aarhus University Hospital Aarhus Denmark

3. Department of Cardiology Aalborg University Hospital Aalborg Denmark

4. Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark

Abstract

AbstractBackgroundPatients with acute coronary syndromes (ACS) may have worse outcomes after percutaneous coronary intervention compared to patients without ACS.AimsTo compare 5‐year efficacy and safety outcomes in patients with and without ACS treated with biodegradable polymers, the ultrathin strut sirolimus‐eluting Orsiro stent (O‐SES) or the biolimus‐eluting Nobori stent (N‐BES).MethodsThe Scandinavian Organisation for Randomized Trials with Clinical Outcome VII is a randomized trial comparing O‐SES and N‐BES in an all‐comer setting. Of 2525 patients, 1329 (53%) patients had ACS and 1196 (47%) patients were without ACS. Endpoints were target lesion failure (TLF) (a composite of cardiac death, target lesion myocardial infarction, or target lesion revascularization) and definite stent thrombosis within 5 years.ResultsAt 5‐year follow‐up, TLF did not differ significantly between patients with and without ACS (12.3% vs. 13.2%; rate ratio (RR) 1.00; 95% confidence interval (CI): 0.70–1.44), whereas the risk of definite stent thrombosis was increased in patients with ACS (2.3% vs. 1.3; RR: 2.01 [95% CI: 1.01–3.98]). In patients with ACS, the rate of TLF was similar between O‐SES and N‐BES (12.4% vs. 12.3%; RR: 1.02; 95% CI: 0.74–1.40). The reduced risk of definite stent thrombosis in O‐SES treated ACS patients within the first year (0.2% vs. 1.6%; RR: 0.12; 95% CI: 0.02–0.93) was not maintained after 5 years (1.8% vs. 2.7%; RR: 0.77; 95% CI: 0.37–1.63).ConclusionPatients with ACS had an increased risk of stent thrombosis regardless of the stent type used. Long‐term outcomes were similar for ACS patients treated with O‐SES or N‐BES at 5 years.

Publisher

Wiley

Subject

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

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