{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T22:23:00Z","timestamp":1776291780291,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Interventional Cardiology"],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:p>Background. While thinner struts are associated with improved clinical outcomes in bare-metal stents (BMS), reducing strut thickness may affect drug delivery from drug-eluting stents (DES) and there are limited data comparing otherwise similar thin and thick strut DES. We assessed 2-year outcomes of patients treated with a thin strut (84\u201388um) cobalt-chromium, biodegradable polymer, Biolimus A9-eluting stent (CoCr-BP-BES) and compared these to patients treated with a stainless steel, biodegradable polymer, Biolimus A9-eluting stent (SS-BP-BES). Methods. In total, 1257 patients were studied: 400 patients from 12 centres receiving \u22651 CoCr-BP-BES in the prospective Biomatrix Alpha registry underwent prespecified comparison with 857 patients who received \u22651 Biomatrix Flex SS-BP-BES in the LEADERS study (historical control). The primary outcome was major adverse cardiac events (MACE)\u2014cardiac death, myocardial infarction (MI), or clinically driven target vessel revascularization (cd-TVR). Propensity analysis was used to adjust for differences in baseline variables and a landmark analysis at day-3 to account for differences in periprocedural MI definitions. Results. MACE at 2 years occurred in 6.65% CoCr-BP-BES versus 13.23% SS-BP-BES groups (unadjusted HR 0.48 [0.31\u20130.73]; <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.0005<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). Following propensity analysis, 2-year adjusted MACE rates were 7.4% versus 13.3% (HR 0.53 [0.35\u20130.79]; <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.004<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). Definite or probable stent thrombosis, adjudicated using identical criteria in both studies, occurred less frequently with CoCr-BP-BES (1.12% vs. 3.22%; adjusted HR 0.32 [0.11\u20130.9]; <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.034<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). In day-3 landmark analysis, the difference in 2-year MACE was no longer significant but there was a lower patient-orientated composite endpoint (11.7% vs. 18.4%; HR 0.6 [0.43\u20130.83]; <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.006<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>) and a trend to lower target vessel failure (5.8% vs. 9.1%; HR 0.63 [0.4\u20131.00]; <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.078<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>). Conclusion. At 2-year follow-up, propensity-adjusted analysis showed the thin strut (84\u201388um) Biomatrix Alpha CoCr-BP-BES was associated with improved clinical outcomes compared with the thicker strut (114\u2013120um) Biomatrix Flex SS-BP-BES.<\/jats:p>","DOI":"10.1155\/2021\/6654515","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T20:50:10Z","timestamp":1617310210000},"page":"1-7","source":"Crossref","is-referenced-by-count":10,"title":["Thin Strut CoCr Biodegradable Polymer Biolimus A9-Eluting Stents versus Thicker Strut Stainless Steel Biodegradable Polymer Biolimus A9-Eluting Stents: Two-Year Clinical Outcomes"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-4350","authenticated-orcid":true,"given":"Ian B. A.","family":"Menown","sequence":"first","affiliation":[{"name":"Craigavon Cardiac Centre and Queens University, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":true,"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"University Hospital of North Midlands NHS Trust, Keele University, Keele, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6548-2723","authenticated-orcid":true,"given":"James M.","family":"Cotton","sequence":"additional","affiliation":[{"name":"Royal Wolverhampton NHS Trust, Wolverhampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1147-1436","authenticated-orcid":true,"given":"David","family":"Hildick-Smith","sequence":"additional","affiliation":[{"name":"Brighton and Sussex University Hospitals, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8111-9585","authenticated-orcid":true,"given":"Franz R.","family":"Eberli","sequence":"additional","affiliation":[{"name":"Triemli Hospital, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-5397","authenticated-orcid":true,"given":"Gregor","family":"Leibundgut","sequence":"additional","affiliation":[{"name":"Kantonsspital Baselland, Liestal, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damras","family":"Tresukosol","sequence":"additional","affiliation":[{"name":"Her Majesty Cardiac Center, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Macaya","sequence":"additional","affiliation":[{"name":"Hospital Clinico San Carlos, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-9729","authenticated-orcid":true,"given":"Samuel","family":"Copt","sequence":"additional","affiliation":[{"name":"Biosensors Clinical Research, Morges, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0569-1491","authenticated-orcid":true,"given":"Sara Sadozai","family":"Slama","sequence":"additional","affiliation":[{"name":"Biosensors Clinical Research, Morges, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7842-3463","authenticated-orcid":true,"given":"Keith G.","family":"Oldroyd","sequence":"additional","affiliation":[{"name":"Biosensors Clinical Research, Morges, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.103.23.2816"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.07.040"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2020.100472"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(08)61244-1"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.04.011"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31826e1058"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.685313"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy223"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.1985.10479383"},{"issue":"19","key":"10","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B","article-title":"Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group","volume":"17","author":"R. 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