Long-Term Clinical Outcomes Between Biodegradable and Durable Polymer Drug-Eluting Stents: A Nationwide Cohort Study

Area of Science:

• Cardiovascular Medicine
• Biomaterials Science
• Interventional Cardiology

Background:

• Biodegradable polymer drug-eluting stents (BP-DES) offer theoretical advantages over durable polymer DES (DP-DES).
• Clinical evidence comparing BP-DES and DP-DES long-term outcomes remains limited.
• A large-scale nationwide cohort study was conducted to address this knowledge gap.

Purpose of the Study:

• To compare the long-term clinical outcomes of patients treated with BP-DES versus DP-DES.
• To evaluate the safety and efficacy of different drug-eluting stent polymer types.

Main Methods:

• Retrospective cohort study using the Korean National Health Insurance Service database (2010-2016).
• Inclusion of patients undergoing percutaneous coronary intervention (PCI) with new-generation DES (thin struts <90 μm).
• Statistical analysis using stabilized inverse probability of treatment weighting to compare outcomes.

Main Results:

• Analysis of 127,731 patients showed BP-DES was associated with significantly lower all-cause death at 5 years (11.3% vs. 13.0%, HR 0.92).
• BP-DES use also demonstrated lower cardiovascular death (7.4% vs. 9.6%) and myocardial infarction (MI) (7.4% vs. 8.7%) at 5 years.
• No significant differences in outcomes were observed at the 2-year follow-up.

Conclusions:

• BP-DES implantation is linked to a reduced risk of all-cause death, cardiovascular death, and MI compared to DP-DES.
• The benefits of BP-DES become more evident at the 5-year follow-up mark.
• This study supports the long-term clinical advantage of biodegradable polymer drug-eluting stents.