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Published on: May 14, 2013
Clinical Outcomes of Biodegradable versus Durable Polymer Drug Eluting Stents in Rotational Atherectomy: Results from
Kyung An Kim1, Sung-Ho Her2, Kyusup Lee3
1Department of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 65091, Korea.
Insights
Biodegradable polymer drug-eluting stents (BP-DES) showed better outcomes than durable polymer DES in patients with calcified coronary lesions after rotational atherectomy. BP-DES reduced all-cause and cardiovascular mortality, improving patient survival.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Calcified coronary lesions pose challenges for percutaneous coronary intervention (PCI).
- Drug-eluting stents (DES) are crucial for managing these lesions.
- The choice between biodegradable polymer (BP) and durable polymer (DP) DES in this context requires further clinical comparison.
Purpose of the Study:
- To compare the clinical outcomes of BP-DES versus DP-DES in patients with calcified coronary lesions undergoing rotational atherectomy (RA) and PCI.
- To evaluate the impact of stent polymer type on mortality and major adverse cardiac events.
Main Methods:
- A multicenter registry study including patients with calcified coronary artery disease who underwent PCI with RA.
- Enrollment from January 2010 to October 2019 across 9 tertiary centers in Korea.
- Primary outcome: 3-year all-cause mortality; Secondary outcomes: cardiovascular death and target-lesion failure (TLF).
- Propensity score matching and multivariate Cox regression analyses were performed.
Main Results:
- A total of 540 patients were analyzed (272 DP-DES, 238 BP-DES).
- PCI with BP-DES was associated with significantly decreased all-cause mortality (HR 0.414) and cardiovascular mortality.
- No significant difference in target-lesion failure (TLF) was observed between BP-DES and DP-DES groups.
Conclusions:
- Biodegradable polymer DES demonstrate favorable clinical outcomes compared to durable polymer DES in patients with calcified coronary lesions treated with RA and PCI.
- BP-DES may offer a survival benefit in this complex patient population.
- Further research may explore long-term efficacy and safety profiles.
Background:
The aim of this study was to compare the clinical outcomes of biodegradable polymer (BP) versus durable polymer (DP) drug eluting stents (DES) in patients with calcified coronary lesions who underwent rotational atherectomy (RA) and percutaneous coronary intervention (PCI).
Methods:
This study was based on a multicenter registry which enrolled patients with calcified coronary artery disease who received PCI using RA during between January 2010 and October 2019 from 9 tertiary centers in Korea. The primary outcome was 3-year all-cause mortality, and the secondary outcomes were cardiovascular death and target-lesion failure.
Results:
A total of 540 patients who underwent PCI using RA were enrolled with a follow-up period of median 16.1 months. From this registry, 272 patients with PCI using DP-DES and 238 patients with BP-SGDES were selected for analysis. PCI with BP-DES was associated with decreased all-cause mortality after propensity score matching (HR 0.414, CI 0.174-0.988) and multivariate Cox regression analysis (HR 0.458, HR 0.224-0.940). BP-DES was also associated with decreased cardiovascular mortality, but there was no difference in TLF between the two groups.
Conclusions:
BP-DES were associated with favorable outcomes compared to DP-DES in patients undergoing PCI using RA for calcified coronary lesions.
