Long‐term outcomes after coronary intervention with biodegradable polymer stents in patients with acute coronary syndromes
Manijeh Noori, Evald Høj Christiansen, Bent Raungaard, Anders Junker, Martin Kirk Christensen, Johnny Kahlert, Michael Maeng, Phillip Freeman, Kirstine Nørregaard Hansen, Christian Juhl Terkelsen, Julia Ellert‐Gregersen, Steen Dalby Kristensen, Karsten Tange Veien, Lars Jakobsen, Lisette Okkels Jensen- Cardiology and Cardiovascular Medicine
- Radiology, Nuclear Medicine and imaging
- General Medicine
Abstract
Background
Patients with acute coronary syndromes (ACS) may have worse outcomes after percutaneous coronary intervention compared to patients without ACS.
Aims
To 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).
Methods
The 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.
Results
At 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).
Conclusion
Patients 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.