Real-world evidence of BioMime sirolimus-eluting stent in obstructive coronary artery disease: the meriT-2 trial.

AsiaIntervention Pub Date : 2024-09-27 eCollection Date: 2024-09-01 DOI:10.4244/AIJ-D-24-00007
Upendra Kaul, Gurpreet S Wander, Ajit Mullasari, Manjunath C Nanjappa, Prabhakar Heggunje-Shetty, Thomas Alexander, Suhas Hardas, Sunita Abraham, Samuel K Mathew, Suresh Vijan, Rohit K Manoj, Udita Chandra, Ashokkumar Thakkar
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Abstract

Background: The efficacy and safety of the ultrathin BioMime sirolimus-eluting coronary stent (SES) system in treating single or multiple de novo native coronary lesions, in-stent restenosis, and bifurcation lesions have been evidenced at 1 year.

Aims: We sought to investigate the long-term safety and efficacy of the BioMime SES in a real-world population with obstructive coronary artery disease (CAD).

Methods: The prospective, single-arm, multicentre meriT-2 trial enrolled 250 patients from 11 sites across India. The safety endpoint was the cumulative frequency of major adverse cardiovascular events (MACE) at 5 years, defined as a composite of cardiac death, myocardial infarction (MI), emergent coronary artery bypass grafting or clinically indicated target lesion revascularisation (CI-TLR). Stent thrombosis (ST) was evaluated according to the Academic Research Consortium definitions.

Results: A total of 214 (85.6%) subjects completed the 5-year follow-up. The mean age of patients was 57.44±10.75 years, and 82.71% were males. A total of 308 lesions were treated with BioMime SES. Most of the lesions were localised in the left anterior descending artery (45.46%) and were type B2 lesions (44.81%). The cumulative MACE rate at 5 years was 8.9% (n=19), including 0.9% cardiac deaths, 1.9% MI and 6.1% CI-TLR. The rate of ST was only 0.5%. The Kaplan-Meier survivor analysis revealed actuarial survivorship of 95.6% for the intention-to-treat population (n=250) over 5 years.

Conclusions: The long-term clinical outcomes of the meriT-2 trial established the safety and efficacy of the ultrathin-strut biodegradable-polymer-based BioMime SES with satisfactory clinical outcomes at 5 years.

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BioMime西罗莫司洗脱支架治疗阻塞性冠状动脉疾病的真实世界证据:meriT-2试验。
背景:超薄 BioMime 西罗莫司洗脱冠状动脉支架(SES)系统治疗单个或多个原发性冠状动脉病变、支架内再狭窄和分叉病变的疗效和安全性已在 1 年后得到证实。目的:我们试图研究 BioMime SES 在现实世界中阻塞性冠状动脉疾病(CAD)患者中的长期安全性和疗效:前瞻性、单臂、多中心 meriT-2 试验在印度 11 个地点招募了 250 名患者。安全性终点为5年内主要不良心血管事件(MACE)的累积频率,定义为心源性死亡、心肌梗死(MI)、急诊冠状动脉旁路移植术或临床指征靶病变血运重建(CI-TLR)的综合结果。支架血栓(ST)根据学术研究联盟的定义进行评估:共有 214 名受试者(85.6%)完成了为期 5 年的随访。患者的平均年龄为(57.44±10.75)岁,82.71%为男性。共有 308 个病灶接受了 BioMime SES 治疗。大部分病变位于左前降支动脉(45.46%),为B2型病变(44.81%)。5年的累积MACE率为8.9%(n=19),包括0.9%的心源性死亡、1.9%的心肌梗死和6.1%的CI-TLR。ST率仅为0.5%。卡普兰-梅耶尔存活率分析显示,意向治疗人群(n=250)5年的精算存活率为95.6%:meriT-2试验的长期临床结果证明了基于生物可降解聚合物的超薄支架BioMime SES的安全性和有效性,5年的临床结果令人满意。
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