Comparative clinical performance of two types of drug-eluting stents with abluminal biodegradable polymer coating: Five-year results of the DESTINY randomized trial

• Published in: Revista portuguesa de cardiologia (English ed.) 2021-02, Vol.40 (2), p.71-76
• Main Authors: Prado Jr, Guy F.A., Abizaid, Alexandre A.C., Meireles, George C., Sarmento-Leite, Rogério, Prudente, Mauricio, Cantarelli, Marcelo, Dourado, Adriano D., Jr, Jose Mariani, Perin, Marco A., Costantini, Costantino, Costa, Ricardo, Costa, J. Ribamar, Chamie, Daniel, Campos, Carlos M., Ribeiro, Expedito E., Lemos, Pedro A.
• Format: Article
• Language: English
• Subjects: Biodegradable polymers; Drug-eluting stent; Intravascular ultrasound; Optical coherence tomography; Polímero biodegradável; Stent farmacológico; Stent thrombosis; Tomografia de coerência óptica; Trombose de stent; Ultrassom intracoronário
• ISSN: 2174-2049; 2174-2049
• DOI: 10.1016/j.repce.2020.05.024

The Stents Coated With the Biodegradable Polymer on Their Abluminal Faces and Elution of Sirolimus Versus Biolimus Elution for the Treatment of de Novo Coronary Lesions – DESTINY Trial is a non-inferiority randomized study that compared the Inspiron™ sirolimus-eluting stent (SES) with the control Biomatrix™ Flex biolimus-eluting stent (BES). Previous reports in the first year showed similar outcomes for both stents, in clinical, angiographic, optical coherence tomography, and intravascular ultrasound assessments. The present analysis aims to compare the clinical performance of these two biodegradable polymer drug-eluting stents five years after the index procedure. A total of 170 patients (194 lesions) were randomized in a 2:1 ratio for treatment with SES or BES, respectively. The primary endpoint for the present study was the five-year rate of combined major adverse cardiac events, defined as cardiac death, myocardial infarction, or target lesion revascularization. At five years, the primary endpoint occurred in 12.5% and 17.9% of the SES and BES groups, respectively (p=0.4). There was no definite or probable stent thrombosis among patients treated with the novel SES stent during the five years of follow-up, and no stent thrombosis after the first year in the BES group. The novel Inspiron™ stent had similar good clinical performance in long-term follow-up when compared head-to-head with the control latest-generation Biomatrix™ Flex biolimus-eluting stent. Stents Coated with the Biodegradable Polymer on their Abluminal Faces and Elution of Sirolimus Versus Biolimus Elution for the Treatment of de Novo Coronary Lesions (DestinyTrial) é um estudo randomizado de não inferioridade que comparou o stent farmacológico eluído com Sirolimus Inspiron® (SES) ao controle o stent Biomatrix® Flex eluído com biolimus (BES). Relatórios dentro do primeiro ano mostraram resultados semelhantes para ambos os stents, em seguimento clínico, angiográfico e também em análise de tomografia de coerência ótica e ultrassom intracoronário. A presente análise tem como objetivo comparar o desempenho clínico desses dois stents farmacológicos com polímeros biodegradáveis após cinco anos do procedimento índice. Foram randomizados 170 pacientes (194 lesões) em uma proporção de 2:1 para tratamento com SES ou BES, respetivamente. O desfecho primário para o presente estudo foi a taxa em cinco anos de eventos cardíacos adversos maiores combinados, definida como morte cardíaca, infarto do miocár