Efficacy and safety of durable versus biodegradable polymer drug-eluting stents in patients with acute myocardial infarction complicated by cardiogenic shock

Sci Rep. 2024 Mar 15;14(1):6301. doi: 10.1038/s41598-024-56925-2.

Abstract

The clinical impact of different polymer technologies in newer-generation drug-eluting stents (DESs) for patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains poorly understood. We investigated the efficacy and safety of durable polymer DESs (DP-DESs) compared with biodegradable polymer DESs (BP-DESs). A total of 620 patients who underwent percutaneous coronary intervention with newer-generation DESs for AMI complicated by CS was divided into two groups based on polymer technology: the DP-DES group (n = 374) and the BP-DES group (n = 246). The primary outcome was target vessel failure (TVF) during a 12-month follow-up, defined as a composite of cardiac death, myocardial infarction, or target vessel revascularization. Both the DP-DES and BP-DES groups exhibited low stent thrombosis rates (1.3% vs. 1.6%, p = 0.660). The risk of TVF did not significantly differ between the two groups (34.2% vs. 28.5%, hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.69-1.29, p = 0.721). This finding remained consistent after adjustment with inverse probability of treatment weighting (28.1% vs. 25.1%, HR 0.98, 95% CI 0.77-1.27, p = 0.899). In AMI patients complicated by CS, the risk of a composite of cardiac death, myocardial infarction, or target vessel revascularization was not significantly different between those treated with DP-DESs and those treated with BP-DESs.Trial registration: RESCUE registry, https://clinicaltrials.gov/ct2/show/NCT02985008 , NCT02985008.

Keywords: Cardiogenic shock; Drug-eluting stent; Myocardial infarction; Polymers.

Publication types

  • Clinical Trial

MeSH terms

  • Absorbable Implants
  • Death
  • Drug-Eluting Stents* / adverse effects
  • Humans
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / therapy
  • Percutaneous Coronary Intervention*
  • Polymers
  • Prosthesis Design
  • Shock, Cardiogenic / complications
  • Shock, Cardiogenic / therapy
  • Treatment Outcome

Substances

  • Polymers

Associated data

  • ClinicalTrials.gov/NCT02985008