COMPARE II: STEMI Patients See Strong Results with Both BES and EES

 

A biodegradable polymer-coated, biolimus-eluting stent (BES) is as safe as durable polymer-coated, everolimus-eluting stents (EES) at 3 years in STEMI patients, according to a subanalysis of the all-comers COMPARE II trial presented at TCT 2014.

Georgios Vlachojannis, MD, PhD, of Maasstad Hospital in Rotterdam, the Netherlands, and colleagues compared outcomes of the 569 STEMI patients — 21% of the total COMPARE II cohort — who underwent primary PCI with either EES (n=197; Xience, Abbott Vascular or Promus, Boston Scientific) or BES (n=372; Nobori, Terumo) at 12 European centers.

The groups were similar with regard to rates of the prespecified primary endpoint of MACE (cardiac death or nonfatal MI) along with clinically indicated TVR and TLR and definite/probable stent thrombosis (see Table).

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 Because of the low event rates, Vlachojannis told TCT Daily that the results “have to be regarded as hypothesis generating and remain to be confirmed by properly powered studies.”

Biodegradable stents were designed to reduce late adverse events such as the stent thrombosis seen with first-generation DES; newer-generation, permanent-polymer DES, however, also have very low rates of late events, Vlachojannis noted. He added that in the STEMI subgroup of COMPARE II, both EES and BES had definite/probable stent thrombosis rates that were less than half those reported in the HORIZONS-AMI trial with first-generation DES.

“It appears that the opportunity to demonstrate safety benefits — ie, lower stent thrombosis rates — in COMPARE II by biodegradable polymer BES is challenged by the excellent safety performance of the durable polymer EES,” Vlachojannis said.

He added that longer follow-up beyond 3 years is still needed to draw more definitive conclusions about any possible benefits of the biodegradable stent and that further studies dedicated to STEMI patients are also warranted.

Disclosures:

  • Vlachojannis reports no relevant conflicts of interest.

 

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