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Polymer-based or polymer-free stents in patients at high bleeding risk

New England Journal of Medicine Mar 31, 2020

Windecker S, Latib A, Kedhi E, et al. - Given superior clinical results with polymer-free drug-coated stents vs bare-metal stents have been achieved in patients at high bleeding risk who were treated with percutaneous coronary intervention (PCI) and 1 month of dual antiplatelet therapy, but there exists limited data regarding the use of polymer-based drug-eluting stents, vs polymer-free drug-coated stents, in such patients, so, researchers undertook this international, randomized, single-blind trial, wherein they compared polymer-based zotarolimus-eluting stents with polymer-free umirolimus–coated stents among patients carrying a high bleeding risk. A safety composite of mortality from cardiac causes, myocardial infarction, or stent thrombosis at 1 year, was considered as the primary outcome. Target-lesion failure, an effectiveness composite of mortality from cardiac reasons, target-vessel myocardial infarction, or clinically indicated target-lesion revascularization, was regarded as the principal secondary outcome. Both outcomes were powered for noninferiority. According to the findings, the noninferiority of the use of polymer-based zotarolimus-eluting stents to the use of polymer-free drug-coated stents, in terms of safety and effectiveness composite outcomes, was evident among patients at high bleeding risk who were treated with 1 month of dual antiplatelet therapy post-PCI.

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