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The prognostic impact of the Polymer-free (BIOFREEDOM) and the Biodegradable (BIOMATRIX) innovative stent designs in percutaneous coronary intervention
Session:
CO 06 - Intervenção Coronária
Speaker:
Luís Morais
Congress:
CPC 2018
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Luís Almeida Morais; Tiago Pereira Da Silva; Ruben Ramos; António Fiarresga; Lidia De Sousa; Ramiro Sá Carvalho; Luis Bernardes; Lino Patrício ; Dra. Inês Rodrigues; cristina soares; Duarte Cacela; Rui Cruz Ferreira
Abstract
<p><strong>Background</strong>: Nowadays, 2<sup>nd</sup> drug-eluting stents (DES) are the mainstay for coronary artery disease (CAD) treatment. However, concerns regarding stent thrombosis, neointimal proliferation and neoatherosclerosis are encouraging the development of new stent platforms. Therefore, new generation polymer-free Biolimus A9-coated stent (BioFreedom®) and biodegradable polymer Biolimus A9-coated stent (Biomatrix®) have recently been divulged. Nonetheless, the clinical prognostic difference between the polymer-free and biodegradable polymer stent, with the same eluting drug, has not been studied. </p> <p><strong>Aim</strong>: to compare the first year major adverse cardiovascular events (MACE) of the polymer-free Biolimus A9-coated stent (BioFreedom®) with a biodegradable polymer Biolimus A9-coated stent (Biomatrix®) in a real world population.</p> <p><strong>Methods: </strong>From April 2014 to December 2016 all patients referred for percutaneous coronary intervention implanting a BioFreedom® stent were compared to those implanting a Biomatrix® stent, in a single tertiary centre, in an all comers prospective registry. Patients implanting other stents concomitantly were excluded. Baseline, coronary lesions and coronary intervention characteristics were evaluated. The primary endpoint was first year MACE rate.</p> <p><strong>Results: </strong>In the BioFreedom® group, 158 patients were included (mean age 63.8±13.1 years old, 75.3% male) with a total 198 stents implanted. The Biomatrix® stent group consisted in 179 patients (mean age 64.6±11.4 years old, 74.9% male) with 231 stents implanted. From the total population, 27.9% presented hypertension, 11.6% diabetes mellitus, 27.6% dyslipidemia and 12.2% were smokers. The classical cardiovascular risk factors were not different between groups at baseline. Stents were implanted in an acute coronary syndrome context in 51.4% in the Biomatrix® group and 59.5% in the Biofreedom® group (p=0.15). 35.8% of patients in the Biomatrix® group and 30.3% in the BioFreedom® group implanted > 1 stent. Coronary lesions type, length, morphology and calcium prevalence were also not different between groups. First year MACE rate were not statistically different between groups (Biomatrix® 6.1% vs. BioFreedom® 6.3%, p 0.99) (graphic), and were not influenced by the clinical risk factors, lesions characteristics or clinical context. </p> <p><strong>Conclusions: </strong>Despite an improved clinical performance of the 2<sup>nd</sup> generation DES over 1<sup>st</sup> generation DES and bare metal stents, concerns regarding stent thrombosis, delayed healing and longer dual anti-platelet therapy have brought to light new stent platforms and designs. In this analysis, the polymer-free Biolimus A9-coated stent showed comparable first year MACE rates with the same drug but biodegradable polymer stent.</p>
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