Bioactive or Drug-Eluting Stents in 75 Years or Older Patients: The BIODES-75 Registry
Por:
Córdoba-Soriano JG, Gutiérrez-Díez A, Del Blanco BG, Núñez J, Amat-Santos IJ, Oteo JF, Romaguera R, Gallardo-López A, Lozano Ruíz-Poveda F, Baello P, Aguar P, Jerez-Valero M, Jiménez-Díaz VA, Serra B, Cascon JD, Morales-Ponce FJ, Portero-Portaz JJ, Melehi El Assali D, Cerrato-García P and Jiménez-Mazuecos J
Publicada:
1 sep 2022
Ahead of Print:
8 feb 2022
Resumen:
Background: TiNO-coated BAS have demonstrated competitive outcomes compared to drug-eluting stents (DES). These devices allow short antiplatelet regimens and may be a good option for the growing elderly population undergoing percutaneous coronary intervention (PCI).
Methods: Multicenter observational trial in routine clinical practice. A propensity-score matched analysis compared a prospective cohort of patients >= 75 years undergoing PCI with BAS, with a contemporary and retrospective cohort treated with last-generation DES. The co-primary endpoints of the study were the Target-LesionFailure (Cardiac death, non-fatal myocardial infarction, or target lesion revascularization) and Major Adverse Cardiovascular Events (total death, non-fatal myocardial infarction, stroke, or new revascularization) at 1 year.
Results: Whole population included 1000 patients, and 326 patients in each group were matched for analysis. No differences in primary endpoints were found: TLF 10.4% vs. 11% (HR 0.96 (Confidence Interval 95%. 0.36-1.7; p = 0.87)) and MACE 163% vs. 17.2% (HR 0.98 (Confidence Interval 95%; 03-1.5, p = 0.93)). Patients treated with BAS received shorter antiplatelets regimens (dual antiplatelet therapy at 1 year, 25.7% vs. 70.6%, p 0.0001), and they presented lower incidence of bleeding (3.7% vs. 11.7%, HR 0.3 (IC 95% 0.16-0.6, p = 0.001)).
Conclusion: In this real-life registry of patients >= 75 years. BAS were similar to the latest-generation DES in terms of efficacy and reduced the duration of the antithrombotic therapy, lowering bleeding events. (C) 2022 Elsevier Inc. All rights reserved.
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