Preferable vascular healing of ultrathin strut biodegradable-polymer sirolimus-eluting stents in patients with acute coronary syndrome

Kawamura, Akito; Egami, Yasuyuki; Kawanami, Shodai; Sugae, Hiroki; Ukita, Kohei; Nakamura, Hitoshi; Matsuhiro, Yutaka; Yasumoto, Koji; Tsuda, Masaki; Okamoto, Naotaka; Matsunaga‐Lee, Yasuharu; Yano, Masamichi; Nishino, Masami; Tanouchi, Jun

doi:10.1007/s12928-022-00842-6

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…And our meta‐analysis indicated a comparable risk of TLF in patients with ACS in a long period (more than 3 years) between the two groups, which was aligned with the subgroup analysis of a previous IPD meta‐analysis of five RCTs 10 . Remarkably, a recent study based on optical coherence tomography (OCT) found that Orsiro ultrathin BP‐SES (O‐SES) exhibited better coverage of struts and thinner neointima compared to Xience thin DP‐EES (X‐EES), which could also support the safety and efficiency of ultrathin BP‐SES by means of intravascular imaging 26 . It remains necessity for further examination with additional clinical evidence whether BP‐SES will exhibit superior performance over thin DP‐DES during an even more extended follow‐up duration.…”

Section: Discussionsupporting

confidence: 74%

“… 10 Remarkably, a recent study based on optical coherence tomography (OCT) found that Orsiro ultrathin BP‐SES (O‐SES) exhibited better coverage of struts and thinner neointima compared to Xience thin DP‐EES (X‐EES), which could also support the safety and efficiency of ultrathin BP‐SES by means of intravascular imaging. 26 It remains necessity for further examination with additional clinical evidence whether BP‐SES will exhibit superior performance over thin DP‐DES during an even more extended follow‐up duration. Additionally, in our current meta‐analysis, none of the risks of CD, TV‐MI, and CD‐TLR was statistically different between the two groups as well.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term safety of ultrathin bioabsorbable‐polymer sirolimus‐eluting stents versus thin durable‐polymer drug‐eluting stents in acute coronary syndrome: A systematic review and meta‐analysis

Li,

Wang,

Wang

et al. 2023

Clinical Cardiology

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BackgroundBecause of the advancement of bioabsorbable polymers and thinner struts, bioabsorbable‐polymer sirolimus‐eluting stents (BP‐SES) with ultrathin struts may be related to superior performance when compared to durable‐polymer drug‐eluting stents (DP‐DES) with thin struts. Nonetheless, the long‐term safety of ultrathin BP‐SES in acute coronary syndrome (ACS) remains unknown.MethodsWe sought to assess the long‐term safety of ultrathin BP‐SES in ACS patients, conducting a thorough meta‐analysis of all relevant trials drawing a comparison between ultrathin BP‐SES and contemporary thin DP‐DES. Target lesion failure (TLF), which includes cardiac death (CD), target‐vessel myocardial infarction (TV‐MI), and clinically driven target lesion revascularization (CD‐TLR) was considered the primary endpoint. Multiple databases comprising Embase, MEDLINE, Cochrane Library, and Pubmed were all thoroughly searched.ResultsThere were seven randomized controlled trials included in our study with 7522 randomized patients with ACS (BP‐SES = 3888, DP‐DES = 3634). TLF occurred in 371 (9.5% in BP‐SES) and 393 (10.8% in DP‐DES) patients, respectively, across a 40.7‐month weighted mean follow‐up, with no statistically significant group differences (risk ratio [RR]: 0.87; 95% confidence interval [CI]: 0.73–1.04; p = .12). Furthermore, no significant differences in cardiac death (RR: 0.96; 95% CI: 0.68–1.35; p = .81), TV‐MI (RR: 0.63; 95% CI: 0.36–1.10; p = .10) and CD‐TLR (RR: 0.77; 95% CI: 0.46–1.29; p = .32) were detected between two groups.ConclusionDuring a follow‐up of 40.7 months, ultrathin BP‐SES and thin DP‐DES had a comparable risk of TLF and its individual components (CD, TV‐MI, and CD‐TLR), indicating that ultrathin BP‐SES held at least the same safety and efficiency as thin DP‐DES presented in patients with ACS.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Long‐term safety of ultrathin bioabsorbable‐polymer sirolimus‐eluting stents versus thin durable‐polymer drug‐eluting stents in acute coronary syndrome: A systematic review and meta‐analysis

Li,

Wang,

Wang

et al. 2023

Clinical Cardiology

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“…Related to neointimal coverage, thinner scaffold struts are certainly advantageous for strut embedding and intimal coverage, as thinner struts lead to better vascular healing, as observed with DES. 26 Furthermore, thinner struts improve scaffold deliverability, along with the increased visibility of radiopaque markers that facilitate scaffold positioning and post-dilatation. Indeed, device success was achieved in all but three devices.…”

Section: Discussionmentioning

confidence: 99%

Safety and performance of the third-generation drug-eluting resorbable coronary magnesium scaffold system in the treatment of subjects with de novo coronary artery lesions: 6-month results of the prospective, multicenter BIOMAG-I first-in-human study

Haude¹,

Włodarczak²,

Schaaf³

et al. 2023

eClinicalMedicine

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“…Unfortunately, there are no randomized studies using optical coherence tomography (OCT) to compare the DTS and the O-SES. Two studies 8,20 compared the vascular healing of the O-SES and the X-EES (Xience) stent in patients with ACS.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, there are no randomized studies using optical coherence tomography (OCT) to compare the DTS and the O‐SES. Two studies 8 , 20 compared the vascular healing of the O‐SES and the X‐EES (Xience) stent in patients with ACS. The proportion of covered strut was significantly higher in the O‐SES group than in the X‐EES group and the O‐SES group had significantly thinner neointima compared to the X‐EES group.…”

Section: Discussionmentioning

confidence: 99%

Impact of acute coronary syndrome on clinical outcomes after revascularization with the dual‐therapy CD34 antibody‐covered sirolimus‐eluting Combo stent and the sirolimus‐eluting Orsiro stent

Jakobsen

Christiansen

Freeman

et al. 2022

Cathet Cardio Intervent

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Objectives: To compare the efficacy and safety of the dual-therapy CD34 antibodycovered sirolimus-eluting Combo stent (DTS) and the sirolimus-eluting Orsiro stent (O-SES) in patients with and without acute coronary syndrome (ACS) included in the SORT OUT X study.Background: The incidence of target lesion failure (TLF) after treatment with modern drug-eluting stents has been reported to be significantly higher in patients with ACS when compared to patients without ACS. Whether the results from the SORT OUT X study apply to patients with and without ACS remains unknown.Methods: In total, 3146 patients were randomized to stent implantation with DTS (n = 1578; ACS: n = 856) or O-SES (n = 1568; ACS: n = 854). The primary end point, TLF, was a composite of cardiac death, target-lesion myocardial infarction (MI), or target lesion revascularization (TLR) within 1 year.Results: At 1 year, the rate of TLF was higher in the DTS group compared to the O-SES group, both among patients with ACS (6.7% vs. 4.1%; incidence rate ratio:1.65 [95% confidence interval, CI: 1.08-2.52]) and without ACS (6.0% vs. 3.2%; incidence rate ratio: 1.88 [95% CI: 1.13-3.14]). The differences were mainly explained by higher rates of TLR, whereas rates of cardiac death and target lesion MI

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Preferable vascular healing of ultrathin strut biodegradable-polymer sirolimus-eluting stents in patients with acute coronary syndrome

Cited by 9 publications

References 25 publications

Long‐term safety of ultrathin bioabsorbable‐polymer sirolimus‐eluting stents versus thin durable‐polymer drug‐eluting stents in acute coronary syndrome: A systematic review and meta‐analysis

Long‐term safety of ultrathin bioabsorbable‐polymer sirolimus‐eluting stents versus thin durable‐polymer drug‐eluting stents in acute coronary syndrome: A systematic review and meta‐analysis

Safety and performance of the third-generation drug-eluting resorbable coronary magnesium scaffold system in the treatment of subjects with de novo coronary artery lesions: 6-month results of the prospective, multicenter BIOMAG-I first-in-human study

Impact of acute coronary syndrome on clinical outcomes after revascularization with the dual‐therapy CD34 antibody‐covered sirolimus‐eluting Combo stent and the sirolimus‐eluting Orsiro stent

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