Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Rev Port Cardiol (Engl Ed). 2021 Feb;40(2):71-76. doi: 10.1016/j.repc.2020.05.017. Epub 2021 Jan 2.
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.
载有可生物降解聚合物的支架在其腔面和洗脱的西罗莫司与洗脱的比马前列素用于治疗新发病变的冠状动脉病变 - DESTINY 试验是一项非劣效性随机研究,比较了 Inspiron™西罗莫司洗脱支架(SES)和对照 Biomatrix™Flex 比马前列素洗脱支架(BES)。第一年的先前报告显示,这两种支架在临床、血管造影、光学相干断层扫描和血管内超声评估方面的结果相似。本分析旨在比较这两种可生物降解聚合物药物洗脱支架在指数手术后五年的临床性能。
共有 170 名患者(194 处病变)按 2:1 的比例随机分为 SES 或 BES 治疗组。本研究的主要终点是五年时联合主要不良心脏事件的发生率,定义为心脏死亡、心肌梗死或靶病变血运重建。
五年时,SES 和 BES 组的主要终点分别为 12.5%和 17.9%(p=0.4)。在五年的随访中,接受新型 SES 支架治疗的患者中没有确定或可能的支架血栓形成,而在 BES 组中,在第一年之后没有支架血栓形成。
与对照的最新一代 Biomatrix™Flex 比马前列素洗脱支架相比,新型 Inspiron™支架在长期随访中具有相似的良好临床性能。