In STEMI, Biodegradable Polymer Sirolimus-Eluting Stents Superior

For patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), there were fewer target lesion failures at one year in those receiving biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents, according to a study published online in The Lancet.

Juan F. Iglesias, M.D., from Geneva University Hospitals and colleagues conducted a randomized clinical trial in patients with acute STEMI undergoing primary PCI. A total of 1,300 patients were randomly assigned to receive either biodegradable polymer sirolimus-eluting stents (649 patients with 816 lesions) or durable polymer everolimus-eluting stents (651 patients with 806 lesions).

The researchers found that the primary composite end point of target lesion failure occurred in 4 and 6 percent of patients treated with biodegradable polymer sirolimus-eluting stents and durable polymer everolimus-eluting stents, respectively (difference, −1.6 percentage points; rate ratio, 0.59; posterior probability of superiority, 0.986). In the 12 months of follow-up, cardiac death, target vessel myocardial reinfarction, clinically indicated target lesion revascularization, and definite stent thrombosis were similar between the treatment groups.

"In the present study, the difference in the primary end point between the two study groups was largely driven by fewer cases of clinically-indicated target lesion revascularization in patients treated with biodegradable polymer sirolimus-eluting stents compared with durable polymer everolimus-eluting stents," the authors write.

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