Evidence map›Paper›PMID 37624364›Full record

Trial reportCirculation2023

Biodegradable-Polymer or Durable-Polymer Stents in Patients at High Bleeding Risk: A Randomized, Open-Label Clinical Trial.

Marco Valgimigli, Adrian Wlodarczak, Ralph Tölg, Béla Merkely, Henning Kelbæk, Jacek Legutko, Stefano Galli, Matthieu Godin, Gabor G Toth, Thibault Lhermusier and 8 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04137510 (A Prospective, Randomized, Multi-center Study to Assess the Safety of the Orsiro Mission Stent Compared to the Resolute Onyx Stent in Subjects at High Risk for Bleeding in Combination With 1-month Dual Antiplatelet Therapy), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04137510 phase4completednot on this map

A Prospective, Randomized, Multi-center Study to Assess the Safety of the Orsiro Mission Stent Compared to the Resolute Onyx Stent in Subjects at High Risk for Bleeding in Combination With 1-month Dual Antiplatelet Therapy (DAPT)

TypeinterventionalSponsorBiotronik AGRan2020 to 2022Enrolled1,948ConditionsCoronary Artery DiseaseArmsPercutaneous coronary intervention
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. 30-Day DAPT in Patients at High Bleeding Risk Undergoing PCI With Biodegradable-Polymer Sirolimus-Eluting Ultra-Thin Stent.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Marco ValgimigliCardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Università della Svizzera Italiana, Lugano, Switzerland (M.V.).ORCID 0000-0002-4353-7110
Adrian WlodarczakPoland Miedziowe Centrum Zdrowia Lubin, Poland (A.W.).
Ralph TölgHerzzentrum der Segeberger Kliniken GmbH, Bad Segeberg, Germany (R.T.).
Béla MerkelySemmelweis University, Heart and Vascular Center, Budapest, Hungary (B.M.).ORCID 0000-0001-6514-0723
Henning KelbækDepartment of Cardiology, Zealand University Hospital, Roskilde, Denmark (H.K.).ORCID 0000-0001-8293-3733
Jacek LegutkoDepartment of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland (J.L.).ORCID 0000-0002-2945-3674
Stefano GalliDepartment of Interventional Cardiology, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy (S.G.).
Matthieu GodinDepartment of Cardiology, Clinique Saint Hilaire, Rouen, France (M.G.).ORCID 0000-0002-8249-9161
Gabor G TothUniversity Heart Center Graz, Department of Cardiology, Medical University Graz, Austria (G.G.T.).ORCID 0000-0002-0283-9091
Thibault LhermusierHôpital de Rangueil, Fédération de Cardiologie, Pôle Cardio-vasculaire et Métabolique, Toulouse, France (T.L.).ORCID 0000-0002-4260-2339
Benjamin HontonDepartment of Interventional Cardiology, Clinique Pasteur, Toulouse, France (B.H.).
Peter Laurenz DietrichDivision of Cardiology, Stadtspital Triemli, Zurich, Switzerland (P.L.D.).ORCID 0009-0007-6500-7616
Francis StammenDepartment of Cardiology, AZ Delta, Roeselare, Belgium (F.S.).
Bert FerdinandeDepartment of Cardiology, Hospital Oost-Limburg Genk, Belgium (B.F.).
Johanne SilvainSorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France (J.S.).ORCID 0000-0002-1901-2808
Davide CapodannoDivision of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," University of Catania, Italy (D.C.).ORCID 0000-0002-5156-7723
Guillaume CaylaCardiology Department, Nîmes University Hospital, Montpellier University, Nîmes, France (G.C.).ORCID 0000-0002-6449-4826
Bioflow-DAPT Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimited information is available on the comparative efficacy and safety of different stent platforms in patients at high bleeding risk undergoing an abbreviated dual antiplatelet therapy duration after percutaneous coronary intervention (PCI). The aim of this study was to compare the safety and effectiveness of the biodegradable-polymer sirolimus-eluting stent with the durable-polymer zotarolimus-eluting stent in patients at high bleeding risk receiving 1 month of dual antiplatelet therapy after PCI.

methodsThe Bioflow-DAPT Study is an international, randomized, open-label trial conducted at 52 interventional cardiology hospitals in 18 countries from February 24, 2020, through September 20, 2021. Patients with a clinical indication to PCI because of acute or chronic coronary syndrome who fulfilled 1 or more criteria for high bleeding risk were eligible for enrollment. Patients were randomized to receive either biodegradable-polymer sirolimus-eluting stents or durable-polymer, slow-release zotarolimus-eluting stents after successful lesion preparation, followed by 1 month of dual antiplatelet therapy and thereafter single antiplatelet therapy. The primary outcome was the composite of death from cardiac causes, myocardial infarction, or stent thrombosis at 1 year, and was powered for noninferiority, with an absolute margin of 4.1% at 1-sided 5% alpha.

resultsA total of 1948 patients at high bleeding risk were randomly assigned (1:1) to receive biodegradable-polymer sirolimus-eluting stents (969 patients) or durable-polymer zotarolimus-eluting stents (979 patients). At 1 year, the primary outcome was observed in 33 of 969 patients (3.6%) in the biodegradable-polymer sirolimus-eluting stent group and in 32 of 979 patients (3.4%) in the durable-polymer zotarolimus-eluting stent group (risk difference, 0.2 percentage points; upper boundary of the 1-sided 95% CI, 1.8; upper boundary of the 1-sided 97.5% CI, 2.1;

conclusionsAmong patients at high risk for bleeding who received 1 month of dual antiplatelet therapy after PCI, the use of biodegradable-polymer sirolimus-eluting stents was noninferior to the use of durable-polymer zotarolimus-eluting stents with regard to the composite of death from cardiac causes, myocardial infarction, or stent thrombosis. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04137510.

Indexed as

Coronary Artery DiseaseDrug-Eluting StentsMyocardial InfarctionPercutaneous Coronary InterventionThrombosisAbsorbable ImplantsEverolimusHumansPlatelet Aggregation InhibitorsPolymersSirolimusStentsTreatment OutcomeEverolimusPlatelet Aggregation InhibitorsPolymersSirolimuszotarolimusaspirindrug-eluting stentshemorrhagerisktherapeutics

Identifiers

PMID37624364
PMCPMC10516164

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.