{"id":8400,"date":"2011-05-24T14:47:46","date_gmt":"2011-05-24T18:47:46","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=8400"},"modified":"2011-07-19T17:44:13","modified_gmt":"2011-07-19T21:44:13","slug":"stent-biowars-erode-or-absorb","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/05\/24\/stent-biowars-erode-or-absorb\/","title":{"rendered":"Stent BioWars: Erode or Absorb?"},"content":{"rendered":"<p>In January 2011, <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/absorbable-stent-approved-now-you-see-it-now-you-dont\/\">we blogged about ABSORB<\/a>, a\u00a0\u00a0<em><strong><a title=\"Bioresorbable stents\" href=\"http:\/\/www.jstage.jst.go.jp\/article\/circj\/75\/3\/75_509\/_article\">bioresorbable stent<\/a><\/strong><\/em>,\u00a0when it received CE approval for use in Europe.<\/p>\n<p>Drug-eluting stents (DES) are composed of a <strong><em>metal scaffold<\/em><\/strong> that is coated with a <strong><em>polymer<\/em><\/strong> containing an <strong><em>antiproliferative agent<\/em><\/strong><em> , <\/em>which is released gradually over the weeks to months after the stent is inserted. \u00a0The durable polymer residue has been implicated as a cause of persistent arterial wall inflammation and delayed vascular healing, which may play a role in the occurrence of late stent thrombosis and restenosis (&gt;12 months after PCI). \u00a0If so, stent polymers that erode after drug release may potentially reduce late complications.<\/p>\n<p>At the EuroPCR 2011 meeting, researchers presented findings of\u00a0a meta-analysis of\u00a0 3 studies (<a title=\"ISAR-TEST-3 study\" href=\"http:\/\/heart.bmj.com\/content\/95\/18\/1489.full.pdf\">ISAR-TEST-3<\/a>, <a title=\"ISAR-TEST-4 study\" href=\"http:\/\/eurheartj.oxfordjournals.org\/content\/30\/20\/2441.long\">ISAR-TEST-4<\/a>, and <a title=\"LEADERS study\" href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0140673608612441\">LEADERS<\/a>, each with 3 years of follow-up)\u00a0of DES with\u00a0either<strong><em> bioerodable polymers<\/em><\/strong> or<em><strong> durable polymers <\/strong><\/em>(i.e., Cypher). Compared with durable polymers, bioerodables were associated with less stent thrombosis (1.2% vs. 2.1%; <em>P<\/em>=0.013) and better outcomes (incidence of cardiac death, MI, and target lesion revascularization, 18.2% vs. 21.1%; <em>P<\/em>=0.04).<\/p>\n<p>Late stent thrombosis and restenosis\u00a0are uncommon occurrences; however, this meta-analysis provided sufficient patient numbers (2358 patients with bioerodable-polymer stents and 1704 patients with Cypher stents) to detect a statistically significant difference in outcomes.<\/p>\n<p><strong><em>If the incidence of late complications after DES implantation is reduced by making the polymer disappear, do you think that making the entire stent disappear will be a significant improvement?<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In January 2011, we blogged about ABSORB, a\u00a0\u00a0bioresorbable stent,\u00a0when it received CE approval for use in Europe. Drug-eluting stents (DES) are composed of a metal scaffold that is coated with a polymer containing an antiproliferative agent , which is released gradually over the weeks to months after the stent is inserted. \u00a0The durable polymer residue [&hellip;]<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,9,16],"tags":[852,440,331,301,437],"class_list":["post-8400","post","type-post","status-publish","format-standard","hentry","category-general","category-interventional-cardiology","category-vascular","tag-absorb-stent","tag-cypher","tag-des","tag-pci","tag-stents"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8400","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=8400"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8400\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=8400"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=8400"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=8400"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}