One-Year Outcome From an All-Comers Population of Patients With ST-Segment Elevation Myocardial Infarction Treated With Biolimus-Eluting Stent With Biodegradable Polymer Fabrizio Tomai, 1 * MD, FACC, FESC, Leonardo De Luca, 1 MD, PHD, FACC, Luca Altamura, 1 MD, Francesco Versaci, 2 MD, FACC, Mauro Pennacchi, 3 MD, Igino Proietti, 4 MD, Anna S. Ghini, 1 MD, PHD, Pierfrancesco Corvo, 1 MD, Giovanni De Persio, 1 MD, Alessandro Petrolini, 1 MD, Antonella Tommasino, 5 MD, and Gennaro Sardella, 3 MD Objectives: To evaluate the performance of biolimus-eluting stent (BES) in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in a real world clinical scenario. Background: Randomized studies suggest that the BES with biodegradable polymer is more effective and safe than early generation coronary stents in patients with STEMI. Methods: We included all consecu- tive STEMI patients undergoing PCI in this prospective, multicenter registry. The pri- mary endpoint of the study was the rate of major adverse cardiac events (MACE), a composite of cardiac death, recurrent myocardial infarction and ischemia-driven target vessel revascularization at 1-year follow-up. Results: Between June and December 2012 we enrolled 311 STEMI patients. The primary endpoint occurred in 3.2% (95% confidence interval: 1.6–5.8) of patients: cardiac death, re-infarction, and ischemia- driven TVR occurred in 2.3%, 1.3%, and 0.6% of patients, respectively. One-year MACE-free survival was 96.8% 6 1.0%. Conclusions: In a real-world cohort of STEMI patients undergoing PCI, the use of BES is associated with good 1-year clinical out- come. These results confirm and expand previous findings showing the efficacy and safety of BES in the setting of randomized trials. V C 2014 Wiley Periodicals, Inc. Key words: biolimus-eluting stent; biodegradable polymer; ST-elevation myocardial in- farction; real-world registry INTRODUCTION The use of first generation drug-eluting stent (DES) has reduced the incidence of target vessel revasculari- zation (TVR) compared with bare metal stent (BMS), even in the setting of ST-segment elevation myocardial infarction (STEMI) [1,2]. A subgroup analysis of the LEADERS trial showed an improved rate of major adverse cardiac events (MACE) with a new-generation DES, a biolimus-eluting stent (BES) with biodegrad- able polymer, compared with a first-generation DES in patients with STEMI [3]. More recently, in the COM- FORTABLE AMI randomized trial, the use of BES compared with its BMS counterpart, resulted in a lower rate of MACE at 1 year among patients with STEMI undergoing percutaneous coronary intervention (PCI) [4]. This observation would be even more important if confirmed in a non-randomized setting, which may bet- ter reflect patients’ true risk profile and long-term ad- herence to medications, compared with individuals enrolled in clinical trials. 1 Department of Cardiovascular Sciences, European Hospital, Rome, Italy 2 Cardiology Unit, Cardarelli Hospital, Campobasso, Italy 3 Department of Cardiovascular and Respiratory Sciences, Policlinico Umberto I, Rome, Italy 4 Cardiology Unit, M.G. Vannini Hospital, Rome, Italy 5 Cardiology Unit, S. Camillo de Lellis Hospital, Rieti, Italy Conflict of interest: Nothing to report. *Correspondence to: Fabrizio Tomai, MD, FACC, FESC; Department of Cardiovascular Sciences, Division of Cardiology, European Hospital, Via Portuense 700 - 00149 Rome, Italy. E-mail: f.tomai@tiscali.it Received 8 April 2014; Revision accepted 10 August 2014 DOI: 10.1002/ccd.25627 Published online 12 August 2014 in Wiley Online Library (wileyonlinelibrary.com) V C 2014 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 85:352–358 (2015)