title: Comparable clinical safety and efficacy of biodegradable versus durable polymer paclitaxel eluting stents despite shorter dual antiplatelet therapy: insights from a multicenter, propensity score-matched registry.
abstract: BACKGROUND
  The biodegradable polymer drug-eluting stents have been proposed as an alternative to durable polymer DES, theoretically improving vessel healing and reducing the need for prolonged double anti platelet therapy (DAPT), however clinical significance of this technology is under debate. Therefore, we sought to compare the clinical outcomes of two Paclitaxel eluting stents (PES) containing different polymer-based eluting matrices.
  
  
  METHODS
  In this multicenter registry of 392 consecutive patients who underwent PCI between June 2006 and September 2008, we included patients with stable angina or NSTE-ACS displaying at least one significant lesion (>50% diameter stenosis) in native coronary arteries.
  
  
  RESULTS
  Biodegradable polymer PES (BP-PES, LUC Chopin(2) , Balton, Poland) was implanted in 206 patients, whereas durable polymer PES (DP-PES, Taxus, Boston Scientific, USA) was implanted in 186 patients. There were no significant differences in baseline characteristics between groups with the exception of increased diabetes and number of lesions for BP-PES. In risk-unadjusted analysis at 1-year follow-up, there were no significant differences in TLR (BP-PES: 8.4% vs.
  6%; P = 0.36), TVR (BP-PES: 11.1% vs.
  8.4%; P = 0.36) and incidence of stent thromboses (BP-PES: 2.15% vs.
  3.4%; P = 0.42) between groups. There was also no difference in MACCE between groups (17.6% vs. 14.4%, P = 0.49). The mean dual antiplatelet therapy (DAPT) compliance at 1 year was 77% for BP-PES versus 92% for DP-PES (P = 0.03). Kaplan-Meier analysis showed a significantly higher long-term stroke free survival in BP-PES (P = 0.04). After adjustment, this was sustained with an additional tendency toward higher MI free survival for BP-PES (P = 0.059).
  
  
  CONCLUSIONS
  In this observational analysis, BP-PES were comparable to DP-PES, with regard to incidence of repeated revascularizations, stent thromboses and MACCE despite earlier DAPT discontinuation.
authors.affiliation: American Heart of Poland, Katowice, Poland.
authors.forename: Piotr P
authors.initials: PP
authors.lastname: Buszman
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Orlik
authors.forename: Blazej
authors.initials: B
authors.lastname: Trela
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Milewski
authors.forename: Michal
authors.initials: M
authors.lastname: Kozlowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Pruski
authors.forename: Janusz
authors.initials: J
authors.lastname: Drzewiecki
authors.forename: Athanasios
authors.initials: A
authors.lastname: Peppas
authors.forename: Juan F
authors.initials: JF
authors.lastname: Granada
authors.forename: Greg L
authors.initials: GL
authors.lastname: Kaluza
authors.forename: Pawel E
authors.initials: PE
authors.lastname: Buszman
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000401:mortality / Q000517:prevention & control; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011044:Poland / Q000453:epidemiology; D011108:Polymers; D057216:Propensity Score; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D011108:Polymers; D017239:Paclitaxel
keywords: biodegradable polymer; double anti-platelet therapy; durable polymer; paclitaxel eluting stent