Comparison between the Outcomes of Using Biodegradable-Polymer Drug-Eluting Stents and Those of Using Durable-Polymer Drug-Eluting Stents in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

Abd-Allah Y Fawzy; Mahmoud M Kenawi; Ahmed Abd El Aziz; Ayman N Moharam; Ibrahim M Attia

doi:10.3889/oamjms.2019.345

Comparison between the Outcomes of Using Biodegradable-Polymer Drug-Eluting Stents and Those of Using Durable-Polymer Drug-Eluting Stents in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

Open Access Maced J Med Sci. 2019 May 14;7(9):1466-1470. doi: 10.3889/oamjms.2019.345. eCollection 2019 May 15.

Authors

Abd-Allah Y Fawzy¹, Mahmoud M Kenawi¹, Ahmed Abd El Aziz¹, Ayman N Moharam¹, Ibrahim M Attia¹

Affiliation

¹ Critical Care Medicine Department, Cairo University, Cairo, Egypt.

Abstract

Background: Many randomised control studies showed that percutaneous coronary interventions using biodegradable-polymer drug-eluting stents (DES) offer a safe and effective alternative to durable-polymer DES. However, not many studies have discussed its use in the setting of acute coronary syndromes.

Aim: We aim to compare the biodegradable-polymer DES with durable-polymer DES when it comes to reducing the incidence of non-ST elevation acute coronary syndrome (NSTEACS) associated with adverse events.

Methods: We enrolled 205 patients presenting with NSTEACS and a TIMI risk score ≥ 3 in this study and divided them into two groups, group A and group B. Biodegradable-polymer DESs were exclusively used in group A, while durable-polymer DESs were used in group B. Major adverse events were reported in both groups during the hospital stay and patients were followed-up for 1 year.

Results: In our patients, we intervened on 390 diseased segments in a total of 360 vessels. After intervention, TIMI 0 was achieved in 0.97%, TIMI 1 in 1.46%, TIMI 2 in 2.45%, and TIMI 3 in 95.12% of the treated segments (P-value= 0.677). We implanted 121 biodegradable-polymer DESs and 146 durable-polymer DESs. Clinical success was achieved in 95.12% of our cases. We had 55 patients who needed repeated coronary angiography within 1 year (15 patients treated with biodegradable-polymer DES and 24 patients treated with durable-polymer DES). Eighteen patients experienced angina pains (8 patients treated with biodegradable-polymer DES and 10 patients treated with durable-polymer DES). Only 5 patients needed TLR (2 patients treated with biodegradable-polymer DES and 3 patients treated with durable -polymer DES) (P-value = 0.591), three of them had a myocardial infarction with documented angiographic evidence of significant in-stent restenosis (1 patient treated with biodegradable-polymer DES and 2 patients treated with durable-polymer DESs).

Conclusion: Biodegradable-polymer DES represents a comparable alternative to durable-polymer DES in the setting of acute coronary syndromes.

Keywords: Acute Coronary Syndrome; Biodegradable-Polymer DES; Major Adverse Cardiac Events; Non-ST Segment Elevation.