Ultrathin strut, biodegradable-polymer, sirolimus-eluting stents versus thin-strut, durable-polymer, drug-eluting stents for percutaneous coronary revascularisation in the ST-elevation myocardial infarction (STEMI) population.

Abstract

Background: Drug-eluting stent (DES) design features, including strut thickness, can influence the biological response to percutaneous coronary intervention (PCI). Recent studies suggest the clinical superiority of an ultrathin strut (60 microns), biodegradable-polymer, sirolimus-eluting stent (Orsiro; Biotronik, Berlin, Germany) over a thin-strut (81 microns), permanent-polymer, everolimus-eluting stent (Xience; Abbott, Chicago, IL, USA) in ST elevation myocardial infarction (STEMI) patients undergoing PCI. Objective: We sought to compare the Orsiro stent to current-generation thin-strut, durable-polymer DES in an Australian real-world STEMI population. Methods: Baseline demographics, procedural data, and clinical outcomes for patients undergoing STEMI PCI between 2010 and 2018 from the Melbourne Interventional Group (MIG) registry were evaluated. Long-term mortality (median follow-up 2.2 years) was assessed via linkage with the National Death Index. Results: A total of 4,757 patients were included. The mean age in the Orsiro and thin-strut, durable-polymer DES groups was 64±12.8 and 62.9±12.4 years, respectively (p=0.37). Other clinical and procedural variables were comparable. Conclusion: In a contemporary Australian STEMI PCI cohort, the ultrathin strut, biodegradable-polymer DES was associated with similar 30-day clinical outcomes and long-term mortality as the currently available thin-strut, durable-polymer DES.