Durable Versus Biodegradable Polymer Based Sirolimus Drug Eluting Stent A Prospective Study Of The Very Long Term Outcomes

Background: The debate has been ongoing ever since the use of second generationdrug eluting stents (DES) in daily practice. Several large scale randomized trials havebeen conducted to evaluate the safety and efficacy of the novel DES. The Partner stent(coated with a permanent polymer) and the Excel stent (coated with a biodegradablepolymer) are two different types of sirolimus eluting stents made in China. The mid-term and long-term outcomes have both been investigated and confirmed withpromising perspectives. However the very long-term outcomes are yet to be known. Theaim of this study is to investigate the very long term outcomes of these two types ofDES in current practice.Methods: All consecutive patients undergoing PCI with implantation of Partner orExcel from December2006to December2011at the2ndAffiliated Hospital of DalianMedical University were included. Patients were classified according to stent types.Clinical and procedural risk factors were collected retrospectively. The frequency ofmajor adverse cardiac events (MACE: a composite of death, myocardial infarction andtarget vessel revascularization) and stent thrombosis during a60months follow upperiod were compared.Results:447patients were treated with Partner and536patients were treated withExcel. The MACE rates at60months follow up were7.6%in Partner,6.9%in Excel(HR0.901, CI0.56-1.46, P=0.671). The rates of cardiac death, myocardial infarctionand target vessel revascularization were2.2%versus1.7%(HR0.746, CI0.313-1.8,P=0.527),2.23%versus2.61%(HR1.17, CI0.51-2.7, P=0.705) and2.68%versus1.42%(HR0.55, CI0.223-1.365, P=0.187) respectively. The rates of stent thrombosiswere0.44%versus0.74%(HR1.67, CI0.305-9.1, P=0.549). Conclusion: The results from this non-randomized, single centered prospectivestudy show that both Excel DES and Partner DES have an overall low incidence ofMACE and stent thrombosis. It confirms that both types of drug eluting stent can safelyand efficiently be used in current practice to reduce very long-term outcomes.