Two‐Year Safety and Efficacy of Biodegradable Polymer Drug‐Eluting Stent Versus Second‐Generation Durable Polymer Drug‐Eluting Stent in Patients With Acute Myocardial Infarction: Data from the Korea Acute Myocardial Infarction Registry ( KAMIR )

Background Despite improved long‐term safety of biodegradable polymer ( BP ) drug‐eluting stents ( DES ) compared to first‐generation durable polymer ( DP ) DES , data on the safety and efficacy of BP‐DES compared with second‐generation ( 2G ) DP‐DES in patients with acute myocardial infarction ( AMI ) are limited. Hypothesis To evaluate the safety and efficacy of BP‐DES compared with 2G‐DP‐DES in the higher stent thrombosis ( ST ) risk setting of AMI . Methods A total of 3359 AMI patients who received either BP‐DES (n = 261) or 2G‐DP‐DES (n = 3098) were included from the Korea Acute Myocardial Infarction Registry ( KAMIR ). Differences in baseline clinical and angiographic characteristics were adjusted using a 1:5 propensity score matching analysis (n = 261 for BP‐DES and n = 1305 for 2G‐DP‐DES ). The primary outcome was the incidence of major adverse cardiac events ( MACE ) including all‐cause death, recurrent myocardial infarction (re‐ MI ), and target vessel revascularization ( TVR ). The rate of definite or probable ST was also investigated. Results In adjusted analysis, there was no significant difference between the 2 groups in baseline clinical and angiographic characteristics; 2‐year MACE (10.7% and 9.9% in the BP‐DES group and 2G‐DP‐DES group, respectively, P = 0.679); ST incidence (0.8% vs 0.9%, respectively, P = 1.0), and rates of all‐cause death, re‐ MI , and TVR . By multivariate analysis, old age, diabetes mellitus, renal dysfunction, and left ventricular dysfunction were the independent predictors of MACE after BP‐DES or 2G‐DP‐DES implantation. Conclusions BP‐DES and 2G‐DP‐DES appear to have comparable 2‐year safety and efficacy for the treatment of AMI . However, longer‐term follow‐up is needed.