Comparison of clinical outcomes between biodegradable polymer sirolimus-eluting stents and durable polymer everolimus-eluting stents in octogenarian patients

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of cardiology Pub Date : 2026-08-01 Epub Date: 2026-04-02 DOI:10.1016/j.jjcc.2026.03.015

Masaki Kushi MD, Yuichi Ozaki MD, PhD, FJCC, Keiya Komatsu MD, Ryo Hikida MD, Kenichi Komukai MD, PhD, Yosuke Katayama MD, PhD, Keisuke Satogami MD, PhD, Masahiro Takahata MD, PhD, Teruaki Wada MD, PhD, Manabu Kashiwagi MD, PhD, Yasutsugu Shiono MD, PhD, Akio Kuroi MD, PhD, Takashi Yamano MD, PhD, Takashi Tanimoto MD, PhD, FJCC, Shintaro Kuki MD, PhD, Yasushi Ino MD, PhD, Yasushi Hayashi MD, Hironori Kitabata MD, PhD, FJCC, Atsushi Tanaka MD, PhD

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引用次数: 0

Abstract

Background

Biodegradable polymer sirolimus-eluting stents (BP-SESs) have provided similar clinical outcomes including cardiac death, myocardial infarction (MI), and target lesion revascularization to second-generation durable polymer everolimus-eluting stents (DP-EESs). However, safety and efficacy of BP-SES in patients aged ≥80 years remain unknown. The aim of this study was to investigate the 1-year clinical outcomes between BP-SES and DP-EES in patients aged ≥80 years.

Methods

We retrospectively analyzed 213 patients aged ≥80 years who underwent percutaneous coronary intervention (PCI) with BP-SES or DP-EES between April 2020 and March 2022. The primary endpoint was a 1-year composite of all-cause death, MI, target vessel revascularization (TVR), cerebrovascular accident (CVA), and definite or probable stent thrombosis (ST). To minimize stent selection bias, propensity score matching was conducted. Multivariable logistic regression was used to identify factors associated with the 1-year primary endpoint in the matched cohort.

Results

Among 213 patients treated with BP-SES (n = 93) and DP-EES (n = 120), the 1-year rates of MI, TVR, CVA, ST, and bleeding events were similar between the two groups. After propensity score matching, 1-year event-free survival for the primary endpoint was similar between the BP-SES and DP-EES groups [hazard ratio, 0.893; 95% confidence interval (CI), 0.345–2.315; p = 0.816]. Multivariable analysis demonstrated that acute coronary syndrome [odds ratio (OR), 3.478; 95% CI, 1.019–14.190; p = 0.047] was independently associated with a higher incidence of the 1-year primary endpoint, whereas angiographic success (OR, 0.058; 95% CI, 0.008–0.347; p = 0.002) and angiotensin-converting enzyme inhibitor or angiotensin II type 1 receptor blocker use at discharge (OR, 0.229; 95% CI, 0.057–0.858; p = 0.029) were independently associated with a lower incidence.

Conclusions

In patients aged ≥80 years, 1-year clinical outcomes after PCI with BP-SES were generally consistent with those with DP-EES.

Abstract Image

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可生物降解聚合物西罗莫司洗脱支架与耐用聚合物依维莫司洗脱支架在八十多岁患者中的临床效果比较。

生物可降解聚合物西罗莫司洗脱支架（BP-SESs）与第二代耐用聚合物依维莫司洗脱支架（DP-EESs）具有相似的临床结果，包括心源性死亡、心肌梗死（MI）和靶病变血供重建。然而，BP-SES在≥80 岁患者中的安全性和有效性尚不清楚。本研究的目的是研究BP-SES和DP-EES在≥80 岁患者中的1年临床结果。方法：我们回顾性分析了2020年4月至2022年3月期间接受BP-SES或DP-EES经皮冠状动脉介入治疗（PCI）的213例年龄≥80 岁的患者。主要终点是1年的全因死亡、心肌梗死、靶血管重建术（TVR）、脑血管意外（CVA）和明确或可能的支架血栓形成（ST）。为了尽量减少支架选择偏差，进行了倾向评分匹配。使用多变量逻辑回归来确定与匹配队列中1年主要终点相关的因素。结果：在213例BP-SES （n = 93）和DP-EES （n = 120）治疗的患者中，两组1年内MI、TVR、CVA、ST和出血事件发生率相似。倾向评分匹配后，BP-SES组和DP-EES组主要终点的1年无事件生存率相似[风险比，0.893；95%置信区间（CI）， 0.345-2.315；p = 0.816]。多变量分析显示急性冠脉综合征[优势比（OR）， 3.478；95% ci, 1.019-14.190；p = 0.047]与较高的1年主要终点发生率独立相关，而血管造影成功（OR, 0.058; 95% CI, 0.008-0.347; p = 0.002）和出院时使用血管紧张素转换酶抑制剂或血管紧张素II型1受体阻滞剂（OR, 0.229; 95% CI, 0.057-0.858; p = 0.029）与较低的发生率独立相关。结论：在年龄≥80 岁的患者中，BP-SES PCI术后1年临床结果与DP-EES基本一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

8.00%

发文量

202

审稿时长

29 days

期刊介绍： The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.