Patient outcomes three years after percutaneous coronary intervention (PCI) appear to be comparable if clinicians use a polymer-free drug-eluting stent (DES) or a permanent polymer DES, according to a new analysis in JACC: Cardiovascular Interventions.
“The presence of a permanent polymer coating has been shown to be a potential inductor of inflammatory reactions, which may add to the development of neoatherosclerosis causing in-stent restenosis and subsequent target lesion revascularization,” wrote lead author Nicole D. van Hemert, MD, a cardiologist at University Medical Center Utrecht in the Netherlands, and colleagues. “Advances in newer generation DES include the design and thickness of the stent, alternatives for durable polymer coatings, and enhancement of the antiproliferative agent and its deliverability.”
The ReCre8 trial had already confirmed that the polymer-free amphilimus-eluting stent (PF-AES) was clinically noninferior to the permanent polymer zotarolimus-eluting stent (PP-ZES) after one year. This updated analysis examined outcomes after a full three years.
The study included nearly 1,500 patients who underwent elective or emergent PCI with a PF-AES or PP-ZES. Between one and three years of follow-up, the target lesion failure (TLF) occurred in 5.1% of PF-AES patients and 4.9% of PP-ZES patients. The composite of all-cause mortality, any myocardial infarction, unplanned revascularization, stroke and major bleeding was seen in 10.8% of PF-AES patients and 12.9% of PP-ZES patients.
Also, there were no cases of very late stent thrombosis in the PF-AES group and just one case in the PP-ZES group.
“This landmark analysis with final results of the ReCre8 trial confirms that PF-AES are noninferior to PP-ZES regarding TLF in an all-comers population up to 3-year follow-up,” the authors wrote. “There were no differences in the rates of the secondary composite endpoint and the individual endpoint components.”
Read the full study here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.