Comparison of the Safety and Efficacy of Biodegradable Polymer Biolimus-Eluting Stents and Durable Polymer Everolimus-Eluting Stents: Propensity Score-Matched Analysis

Objectives: We investigated and compared the clinical outcomes between biodegradable polymer biolimus-eluting stents (BES) and durable polymer everolimus-eluting stents (EES) in a single-center prospective registry. Background: There is limited data regarding the safety and efficacy of the biodegradable BES compared to second-generation drug-eluting stents. Methods: From January 2010 to April 2012, a total of 1,279 patients were treated with BES (n = 647) or EES (n = 632) in a single center. We included 1,231 patients (BES = 625, EES = 606) after excluding 48 patients (BES = 22, EES = 26) with acute myocardial infarction accompanied by cardiogenic shock. The 1-year incidences of target lesion failure (TLF), patient-oriented composite outcomes (POCO), and stent thrombosis (ST) after the index procedure were compared in propensity score-matched analyses. Results: Propensity score matching yielded 406 well-balanced pairs (EES 406, BES-B 406). In the propensity-matched population, the 1-year incidence of TLF (BES 3.0% vs. EES = 2.5%, P = 0.666) and POCO (BES = 5.4% vs. EES 6.4%, P = 0.552) were similar between the 2 groups. In addition, the incidence of definite or probable ST was also similar (BES = 0.74% vs. EES = 0.74%, P = 1.000). In subgroup analysis, the number of patients who reached the primary end-point did not differ significantly between the 2 groups. Conclusion: In a single-center registry with unrestricted use of EES and BES-B, these stents showed comparable efficacy and safety in terms of TLF, POCO, and ST at 1-year follow-up.