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© Europa Digital & Publishing 2013. All rights reserved.
CLINICAL RESEARCH
EuroIntervention 2013;9:336-344 published online ahead of print March 2013 DOI: 10.4244/EIJV9I3A55
*Corresponding author: Department of Cardiology, University & Hospital Fribourg, 1708 Fribourg, Switzerland.
E-mail: stephane.cook@unifr.ch
Long-term comparison of everolimus-eluting and biolimus-
eluting stents
Serban Puricel, MD; Markus Oberhänsli, MD; Patricia Guntern, SN; Sonja Lehmann, SN; Jean-Jacques Goy, MD;
Diego Arroyo, MD; Hélène Villeneuve, SN; Gérard Baeriswyl, MD; Jean-Christophe Stauffer, MD;
Mario Togni, MD; Stéphane Cook*, MD
Department of Cardiology, University Hospital, Fribourg, Switzerland
S. Puricel and M. Oberhänsli contributed equally to this article.
Abstract
Aims: Second-generation everolimus-eluting stents (EES) are safer and more efficient than first-generation
paclitaxel-eluting stents (PES). Third-generation biolimus-eluting stents (BES) have been found to be non-
inferior to PES. To date, there is no available comparative study between EES and BES. We aimed to inves-
tigate the safety and efficacy of BES with biodegradable polymer compared to EES with durable polymer at
a follow-up of two years in an unselected population of consecutively enrolled patients.
Methods and results: A group of 814 consecutive patients undergoing percutaneous coronary intervention
(PCI) was enrolled between 2007 and 2010, of which 527 were treated with EES and 287 with BES implanta-
tion. Clinical outcome was compared in 200 pairs using propensity score matching. The primary endpoint
was a composite of death, myocardial infarction (MI) and target vessel revascularisation (TVR) at two-year
follow-up. Median follow-up was 22 months. The primary outcome occurred in 11.5% of EES and 10.5% of
BES patients (HR 1.11, 95% CI: 0.61-2.00, p=0.74). At two years, there was no significant difference with
regard to death (HR 0.49, 95% CI: 0.18-1.34, p=0.17), cardiac death (HR 0.14, 95% CI: 0.02-1.14, p=0.66)
or MI (HR 6.10, 95% CI: 0.73-50.9, p=0.10). Stent thrombosis (ST) incidence was evenly distributed between
EES (n=2) and BES (n=2) (p-value=1.0).
Conclusions: This first clinical study failed to demonstrate any significant difference regarding safety or
efficacy between these two types and generations of drug-eluting stents (DES).
KEYWORDS
• drug-eluting stent
• percutaneous
coronary
intervention
• stent thrombosis