Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial
Summary Background The effectiveness of durable polymer drug-eluting stents comes at the expense of delayed arterial healing and subsequent late adverse events such as stent thrombosis (ST). We report the 4 year follow-up of an assessment of biodegradable polymer-based drug-eluting stents, which aim...
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| Veröffentlicht in: | The Lancet (British edition) 2011-12, Vol.378 (9807), p.1940-1948 |
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| creator | Stefanini, Giulio G, MD Kalesan, Bindu, MSc Serruys, Patrick W, Prof Heg, Dik, PhD Buszman, Pawel, Prof Linke, Axel, Prof Ischinger, Thomas, Prof Klauss, Volker, Prof Eberli, Franz, Prof Wijns, William, MD Morice, Marie-Claude, MD Di Mario, Carlo, Prof Corti, Roberto, MD Antoni, Diethmar, MD Sohn, Hae Y, MD Eerdmans, Pedro, PhD van Es, Gerrit-Anne, PhD Meier, Bernhard, Prof Windecker, Stephan, Prof Jüni, Peter, Prof |
| description | Summary Background The effectiveness of durable polymer drug-eluting stents comes at the expense of delayed arterial healing and subsequent late adverse events such as stent thrombosis (ST). We report the 4 year follow-up of an assessment of biodegradable polymer-based drug-eluting stents, which aim to improve safety by avoiding the persistent inflammatory stimulus of durable polymers. Methods We did a multicentre, assessor-masked, non-inferiority trial. Between Nov 27, 2006, and May 18, 2007, patients aged 18 years or older with coronary artery disease were randomly allocated with a computer-generated sequence to receive either biodegradable polymer biolimus-eluting stents (BES) or durable polymer sirolimus-eluting stents (SES; 1:1 ratio). The primary endpoint was a composite of cardiac death, myocardial infarction, or clinically-indicated target vessel revascularisation (TVR); patients were followed-up for 4 years. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT00389220. Findings 1707 patients with 2472 lesions were randomly allocated to receive either biodegradable polymer BES (857 patients, 1257 lesions) or durable polymer SES (850 patients, 1215 lesions). At 4 years, biodegradable polymer BES were non-inferior to durable polymer SES for the primary endpoint: 160 (18·7%) patients versus 192 (22·6%) patients (rate ratios [RR] 0·81, 95% CI 0·66–1·00, p for non-inferiority |
| doi_str_mv | 10.1016/S0140-6736(11)61672-3 |
| format | Article |
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We report the 4 year follow-up of an assessment of biodegradable polymer-based drug-eluting stents, which aim to improve safety by avoiding the persistent inflammatory stimulus of durable polymers. Methods We did a multicentre, assessor-masked, non-inferiority trial. Between Nov 27, 2006, and May 18, 2007, patients aged 18 years or older with coronary artery disease were randomly allocated with a computer-generated sequence to receive either biodegradable polymer biolimus-eluting stents (BES) or durable polymer sirolimus-eluting stents (SES; 1:1 ratio). The primary endpoint was a composite of cardiac death, myocardial infarction, or clinically-indicated target vessel revascularisation (TVR); patients were followed-up for 4 years. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT00389220. Findings 1707 patients with 2472 lesions were randomly allocated to receive either biodegradable polymer BES (857 patients, 1257 lesions) or durable polymer SES (850 patients, 1215 lesions). At 4 years, biodegradable polymer BES were non-inferior to durable polymer SES for the primary endpoint: 160 (18·7%) patients versus 192 (22·6%) patients (rate ratios [RR] 0·81, 95% CI 0·66–1·00, p for non-inferiority <0·0001, p for superiority=0·050). The RR of definite ST was 0·62 (0·35–1·08, p=0·09), which was largely attributable to a lower risk of very late definite ST between years 1 and 4 in the BES group than in the SES group (RR 0·20, 95% CI 0·06–0·67, p=0·004). Conversely, the RR of definite ST during the first year was 0·99 (0·51–1·95; p=0·98) and the test for interaction between RR of definite ST and time was positive ( pinteraction =0·017). We recorded an interaction with time for events associated with ST but not for other events. For primary endpoint events associated with ST, the RR was 0·86 (0·41–1·80) during the first year and 0·17 (0·04–0·78) during subsequent years ( pinteraction =0·049). Interpretation Biodegradable polymer BES are non-inferior to durable polymer SES and, by reducing the risk of cardiac events associated with very late ST, might improve long-term clinical outcomes for up to 4 years compared with durable polymer SES. Funding Biosensors Europe SA, Switzerland.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(11)61672-3</identifier><identifier>PMID: 22075451</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Absorbable Implants ; Acute coronary syndromes ; biodegradability ; Biodegradation ; Biological and medical sciences ; biosensors ; Cardiology. Vascular system ; Cardiovascular disease ; Cell cycle ; Clinical medicine ; coronary artery disease ; Coronary Artery Disease - therapy ; Coronary heart disease ; death ; Drug-Eluting Stents ; Follow-Up Studies ; General aspects ; Grants ; Heart ; Heart attacks ; Humans ; Internal Medicine ; Lesions ; Medical imaging ; Medical sciences ; Myocardial infarction ; patients ; Polymers ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; risk ; Sirolimus - analogs & derivatives ; Stents ; Thromboembolism ; thrombosis ; Thrombosis - etiology</subject><ispartof>The Lancet (British edition), 2011-12, Vol.378 (9807), p.1940-1948</ispartof><rights>Elsevier Ltd</rights><rights>2011 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 3-Dec 9, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-cd2651bd47c680a9a06d89c3356738b6e9f2cc6636643d4626719c02332fb8503</citedby><cites>FETCH-LOGICAL-c500t-cd2651bd47c680a9a06d89c3356738b6e9f2cc6636643d4626719c02332fb8503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673611616723$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25250329$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22075451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stefanini, Giulio G, MD</creatorcontrib><creatorcontrib>Kalesan, Bindu, MSc</creatorcontrib><creatorcontrib>Serruys, Patrick W, Prof</creatorcontrib><creatorcontrib>Heg, Dik, PhD</creatorcontrib><creatorcontrib>Buszman, Pawel, Prof</creatorcontrib><creatorcontrib>Linke, Axel, Prof</creatorcontrib><creatorcontrib>Ischinger, Thomas, Prof</creatorcontrib><creatorcontrib>Klauss, Volker, Prof</creatorcontrib><creatorcontrib>Eberli, Franz, Prof</creatorcontrib><creatorcontrib>Wijns, William, MD</creatorcontrib><creatorcontrib>Morice, Marie-Claude, MD</creatorcontrib><creatorcontrib>Di Mario, Carlo, Prof</creatorcontrib><creatorcontrib>Corti, Roberto, MD</creatorcontrib><creatorcontrib>Antoni, Diethmar, MD</creatorcontrib><creatorcontrib>Sohn, Hae Y, MD</creatorcontrib><creatorcontrib>Eerdmans, Pedro, PhD</creatorcontrib><creatorcontrib>van Es, Gerrit-Anne, PhD</creatorcontrib><creatorcontrib>Meier, Bernhard, Prof</creatorcontrib><creatorcontrib>Windecker, Stephan, Prof</creatorcontrib><creatorcontrib>Jüni, Peter, Prof</creatorcontrib><title>Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary Background The effectiveness of durable polymer drug-eluting stents comes at the expense of delayed arterial healing and subsequent late adverse events such as stent thrombosis (ST). We report the 4 year follow-up of an assessment of biodegradable polymer-based drug-eluting stents, which aim to improve safety by avoiding the persistent inflammatory stimulus of durable polymers. Methods We did a multicentre, assessor-masked, non-inferiority trial. Between Nov 27, 2006, and May 18, 2007, patients aged 18 years or older with coronary artery disease were randomly allocated with a computer-generated sequence to receive either biodegradable polymer biolimus-eluting stents (BES) or durable polymer sirolimus-eluting stents (SES; 1:1 ratio). The primary endpoint was a composite of cardiac death, myocardial infarction, or clinically-indicated target vessel revascularisation (TVR); patients were followed-up for 4 years. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT00389220. Findings 1707 patients with 2472 lesions were randomly allocated to receive either biodegradable polymer BES (857 patients, 1257 lesions) or durable polymer SES (850 patients, 1215 lesions). At 4 years, biodegradable polymer BES were non-inferior to durable polymer SES for the primary endpoint: 160 (18·7%) patients versus 192 (22·6%) patients (rate ratios [RR] 0·81, 95% CI 0·66–1·00, p for non-inferiority <0·0001, p for superiority=0·050). The RR of definite ST was 0·62 (0·35–1·08, p=0·09), which was largely attributable to a lower risk of very late definite ST between years 1 and 4 in the BES group than in the SES group (RR 0·20, 95% CI 0·06–0·67, p=0·004). Conversely, the RR of definite ST during the first year was 0·99 (0·51–1·95; p=0·98) and the test for interaction between RR of definite ST and time was positive ( pinteraction =0·017). We recorded an interaction with time for events associated with ST but not for other events. For primary endpoint events associated with ST, the RR was 0·86 (0·41–1·80) during the first year and 0·17 (0·04–0·78) during subsequent years ( pinteraction =0·049). Interpretation Biodegradable polymer BES are non-inferior to durable polymer SES and, by reducing the risk of cardiac events associated with very late ST, might improve long-term clinical outcomes for up to 4 years compared with durable polymer SES. Funding Biosensors Europe SA, Switzerland.</description><subject>Absorbable Implants</subject><subject>Acute coronary syndromes</subject><subject>biodegradability</subject><subject>Biodegradation</subject><subject>Biological and medical sciences</subject><subject>biosensors</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Cell cycle</subject><subject>Clinical medicine</subject><subject>coronary artery disease</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary heart disease</subject><subject>death</subject><subject>Drug-Eluting Stents</subject><subject>Follow-Up Studies</subject><subject>General aspects</subject><subject>Grants</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Lesions</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Myocardial infarction</subject><subject>patients</subject><subject>Polymers</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>risk</subject><subject>Sirolimus - analogs & derivatives</subject><subject>Stents</subject><subject>Thromboembolism</subject><subject>thrombosis</subject><subject>Thrombosis - etiology</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl2L1DAYhYso7jr6E9QgiLsX1Xy06dQLZVnHDxgQHBe8C2nydszaJmOS7tJf7N8wnZkdcRG8SgjPezg5582yxwS_JJjwVytMCpzzivETQk454RXN2Z3smBRVkZdF9e1udnxAjrIHIVxijAuOy_vZEaW4KouSHGe_ls6u8wi-R6oz1ijZITdE5XoIyLWoMU7D2kstmw7QxnVjD3567Uw_hBy6IRq7RiGCjQFdgQ9DQHrwf-HB-H_zxqKNjGZ7vzbxO1LOOyv9iKRPnkakTQAZAJ0sF2fvFl9Wp69RgUaQHrWu69x1PmwmlxJ5abXrE62RdTY3tgVvnDdxRNEb2T3M7rWyC_Bof86yi_eLr-cf8-XnD5_Oz5a5KjGOudKUl6TRRaX4HMtaYq7ntWKsTDHOGw51S5XinHFeMF1wyitSK0wZo20zLzGbZS92uhvvfg4QokimFHSdtOCGIGo8rwrGGEnks1vkpRu8TeZETTDmVZlUZ1m5g5R3IXhoxcabPgUkCBbTHojtHoipZEGI2O6BmOae7MWHpgd9mLopPgHP94AMqfM25adM-MOVNH2G1ol7uuNa6YRc-8RcrCgmKS1C66KmiXi7IyDFemXAi6BSowq08aCi0M781-ybWwo3q_gDRgiHWIgIVOCdyKRByFaBsd9nJPGJ</recordid><startdate>20111203</startdate><enddate>20111203</enddate><creator>Stefanini, Giulio G, MD</creator><creator>Kalesan, Bindu, MSc</creator><creator>Serruys, Patrick W, Prof</creator><creator>Heg, Dik, PhD</creator><creator>Buszman, Pawel, Prof</creator><creator>Linke, Axel, Prof</creator><creator>Ischinger, Thomas, Prof</creator><creator>Klauss, Volker, Prof</creator><creator>Eberli, Franz, Prof</creator><creator>Wijns, William, MD</creator><creator>Morice, Marie-Claude, MD</creator><creator>Di Mario, Carlo, Prof</creator><creator>Corti, Roberto, MD</creator><creator>Antoni, Diethmar, MD</creator><creator>Sohn, Hae Y, MD</creator><creator>Eerdmans, Pedro, PhD</creator><creator>van Es, Gerrit-Anne, PhD</creator><creator>Meier, Bernhard, Prof</creator><creator>Windecker, Stephan, Prof</creator><creator>Jüni, Peter, Prof</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Limited</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20111203</creationdate><title>Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial</title><author>Stefanini, Giulio G, MD ; Kalesan, Bindu, MSc ; Serruys, Patrick W, Prof ; Heg, Dik, PhD ; Buszman, Pawel, Prof ; Linke, Axel, Prof ; Ischinger, Thomas, Prof ; Klauss, Volker, Prof ; Eberli, Franz, Prof ; Wijns, William, MD ; Morice, Marie-Claude, MD ; Di Mario, Carlo, Prof ; Corti, Roberto, MD ; Antoni, Diethmar, MD ; Sohn, Hae Y, MD ; Eerdmans, Pedro, PhD ; van Es, Gerrit-Anne, PhD ; Meier, Bernhard, Prof ; Windecker, Stephan, Prof ; Jüni, Peter, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-cd2651bd47c680a9a06d89c3356738b6e9f2cc6636643d4626719c02332fb8503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Absorbable Implants</topic><topic>Acute coronary syndromes</topic><topic>biodegradability</topic><topic>Biodegradation</topic><topic>Biological and medical sciences</topic><topic>biosensors</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Cell cycle</topic><topic>Clinical medicine</topic><topic>coronary artery disease</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary heart disease</topic><topic>death</topic><topic>Drug-Eluting Stents</topic><topic>Follow-Up Studies</topic><topic>General aspects</topic><topic>Grants</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Lesions</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Myocardial infarction</topic><topic>patients</topic><topic>Polymers</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stefanini, Giulio G, MD</au><au>Kalesan, Bindu, MSc</au><au>Serruys, Patrick W, Prof</au><au>Heg, Dik, PhD</au><au>Buszman, Pawel, Prof</au><au>Linke, Axel, Prof</au><au>Ischinger, Thomas, Prof</au><au>Klauss, Volker, Prof</au><au>Eberli, Franz, Prof</au><au>Wijns, William, MD</au><au>Morice, Marie-Claude, MD</au><au>Di Mario, Carlo, Prof</au><au>Corti, Roberto, MD</au><au>Antoni, Diethmar, MD</au><au>Sohn, Hae Y, MD</au><au>Eerdmans, Pedro, PhD</au><au>van Es, Gerrit-Anne, PhD</au><au>Meier, Bernhard, Prof</au><au>Windecker, Stephan, Prof</au><au>Jüni, Peter, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2011-12-03</date><risdate>2011</risdate><volume>378</volume><issue>9807</issue><spage>1940</spage><epage>1948</epage><pages>1940-1948</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary Background The effectiveness of durable polymer drug-eluting stents comes at the expense of delayed arterial healing and subsequent late adverse events such as stent thrombosis (ST). We report the 4 year follow-up of an assessment of biodegradable polymer-based drug-eluting stents, which aim to improve safety by avoiding the persistent inflammatory stimulus of durable polymers. Methods We did a multicentre, assessor-masked, non-inferiority trial. Between Nov 27, 2006, and May 18, 2007, patients aged 18 years or older with coronary artery disease were randomly allocated with a computer-generated sequence to receive either biodegradable polymer biolimus-eluting stents (BES) or durable polymer sirolimus-eluting stents (SES; 1:1 ratio). The primary endpoint was a composite of cardiac death, myocardial infarction, or clinically-indicated target vessel revascularisation (TVR); patients were followed-up for 4 years. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov , number NCT00389220. Findings 1707 patients with 2472 lesions were randomly allocated to receive either biodegradable polymer BES (857 patients, 1257 lesions) or durable polymer SES (850 patients, 1215 lesions). At 4 years, biodegradable polymer BES were non-inferior to durable polymer SES for the primary endpoint: 160 (18·7%) patients versus 192 (22·6%) patients (rate ratios [RR] 0·81, 95% CI 0·66–1·00, p for non-inferiority <0·0001, p for superiority=0·050). The RR of definite ST was 0·62 (0·35–1·08, p=0·09), which was largely attributable to a lower risk of very late definite ST between years 1 and 4 in the BES group than in the SES group (RR 0·20, 95% CI 0·06–0·67, p=0·004). Conversely, the RR of definite ST during the first year was 0·99 (0·51–1·95; p=0·98) and the test for interaction between RR of definite ST and time was positive ( pinteraction =0·017). We recorded an interaction with time for events associated with ST but not for other events. For primary endpoint events associated with ST, the RR was 0·86 (0·41–1·80) during the first year and 0·17 (0·04–0·78) during subsequent years ( pinteraction =0·049). Interpretation Biodegradable polymer BES are non-inferior to durable polymer SES and, by reducing the risk of cardiac events associated with very late ST, might improve long-term clinical outcomes for up to 4 years compared with durable polymer SES. Funding Biosensors Europe SA, Switzerland.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>22075451</pmid><doi>10.1016/S0140-6736(11)61672-3</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 2011-12, Vol.378 (9807), p.1940-1948 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_908743331 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Absorbable Implants Acute coronary syndromes biodegradability Biodegradation Biological and medical sciences biosensors Cardiology. Vascular system Cardiovascular disease Cell cycle Clinical medicine coronary artery disease Coronary Artery Disease - therapy Coronary heart disease death Drug-Eluting Stents Follow-Up Studies General aspects Grants Heart Heart attacks Humans Internal Medicine Lesions Medical imaging Medical sciences Myocardial infarction patients Polymers Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) risk Sirolimus - analogs & derivatives Stents Thromboembolism thrombosis Thrombosis - etiology |
| title | Long-term clinical outcomes of biodegradable polymer biolimus-eluting stents versus durable polymer sirolimus-eluting stents in patients with coronary artery disease (LEADERS): 4 year follow-up of a randomised non-inferiority trial |
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