Hot Line III – Acute Coronary Syndromes
It is against this background that newer generation DES, such as everolimus-eluting stents, have been developed, to improve safety with the application of a more biocompatible polymer, along with a reduction in drug dose and reduced strut thickness. Whether these changes in design are sufficient to overcome VLST – the principal limitation of early generation DES – is to date not known.
The Bern-Rotterdam cohort study included more than 12,000 patients treated between 2002 and 2009 at the Bern University Hospital in Switzerland and the Thoraxcenter at Erasmus Medical Centre in Rotterdam, The Netherlands. The objective was to compare the incidence of stent thrombosis between newer generation DES eluting everolimus, and early generation DES eluting srolimus or paclitaxel, with particular focus on stent thrombosis occurring between one and four years (VLST).
Results showed that the rate of stent thrombosis up to four years was lower among patients treated with everolimus-eluting stents (1.4%) than with sirolimus-eluting stents (2.9%, p<0.0001) and paclitaxel-eluting stents (4.4%, p<0.0001). The reduction in stent thrombosis was most prominent between one and four years, resulting in a 67% risk reduction in VLST for the comparison of everolimus-eluting with sirolimus-eluting stents, and a 76 % risk reduction for the comparison of everolimus-eluting with paclitaxel-eluting stents.
Commenting on the results, Dr Räber said: “For the first time we now have robust evidence of the long-term therapeutic benefit of newer generation DES over the early generation DES. The virtual elimination of VLST in our findings provide reassurance of the long-term safety of these devices.”
Doctor Räber, Lorenz (Bern, Switzerland)
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Notes to editor
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Hot Line III – Acute coronary syndromes
Newer generation everolimus-eluting stents eliminate the risk of very late stent thrombosis compared with early generation sirolimus-eluting and paclitaxel-eluting stents
Edited by the ESC from material supplied by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the investigator.