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

Authors

Abd-Allah Y. Fawzy Critical Care Medicine Department, Cairo University, Cairo, Egypt
Mahmoud M. Kenawi Critical Care Medicine Department, Cairo University, Cairo, Egypt
Ahmed Abd El Aziz Critical Care Medicine Department, Cairo University, Cairo, Egypt
Ayman N. Moharam Critical Care Medicine Department, Cairo University, Cairo, Egypt
Ibrahim M. Attia Critical Care Medicine Department, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.345

Keywords:

Non-ST Segment Elevation, Acute Coronary Syndrome, Biodegradable-Polymer DES, Major Adverse Cardiac Events

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 â‰¥ 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.