Two-year follow-up of the DESSOLVE III trial: bioabsorbable polymer sirolimus-eluting stent vs. durable polymer everolimus-eluting stent.

AIMS: To assess whether the 9 months cytostatic inhibition by crystalline sirolimus has a beneficial effect in the 2-year follow-up in all-comer population undergoing percutaneous coronary intervention.

METHODS AND RESULTS: The DESSOLVE III (n=1398) is a prospective, all-comer, multi-centre, randomized controlled study (NCT02385279) allocating 703 patients to receive MiStent drug-eluting stent with a fully absorbable polymer coating containing and embedding a microcrystalline form of sirolimus into the vessel wall and 695 patients to receive Xience durable polymer everolimus-eluting stent. At 2-year, device-oriented composite endpoint (cardiac death, target-vessel myocardial infarction [TV-MI], and clinically-indicated target lesion revascularization [TLR]) occurred 8.7% and 8.6% (p=0.958) and patient-oriented composite endpoint (all deaths, all MI, and all revascularizations) was observed 18.5% and 19.6% (p=0.598) in the MiStent arm and Xience arm, respectively. The frequency of TV-MI and clinically-indicated TLR was also comparable for both stent types. The rate of definite/probable stent thrombosis was not different in both arms (0.9% vs. 1.3%, p=0.435).

CONCLUSIONS: In an all-comer population, at 2-year follow-up, the use of MiStent sirolimus-eluting bioabsorbable polymer-coated stent was at least as safe and efficacious as Xience durable-polymer stent. Through a total of 5 years of follow-up, MiStent's potential long-term clinical benefit will be further elucidated.