The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Abluminal Groove-Filled Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent: 3-Year Results of the TARGET All Comers Trial

DOI: 10.4244/EIJ-D-20-00344

1. Yale University School of Medicine, New Haven, CT, USA
2. Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark;
3. Fu Wai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China;
4. Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, UK;
5. Medizinische Klinik I, Herz-Thorax Zentrum, Klinikum Fulda, Fulda, Germany
6. Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, P. R. China
7. The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, University College Hospital Galway, Galway, Ireland;
8. Barts Heart Centre, London and Queen Mary University of London, London, UK and Yale University School of Medicine, New Haven, CT, USA
9. Barts Heart Centre, London and Queen Mary University of London, London, UK and Yale University School of Medicine, New Haven CT, USA, United Kingdom

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Aims: The Firehawk is a thin-strut coronary stent with a sirolimus and biodegradable polymer complex that are localized in abluminal grooves. The TARGET All Comers study found similar safety and efficacy of the Firehawk compared with the durable polymer everolimus-eluting XIENCE stent at 1- and 2-years follow-up. The aim of this study was to assess comparative clinical outcomes at 3 years. 

Methods and results: The TARGET All Comer study is a prospective, multicenter, randomized, non-inferiority trial. A total of 1653 patients were randomly allocated to receive either the Firehawk or XIENCE stent. The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization. At 3-year follow-up, TLF occurred in 11.9% in the Firehawk group and 11.5% in the XIENCE group (p=0.84). The event rates of individual components of TLF were comparable for the 2 groups. Landmark analyses between 1 and 3 years showed no significant difference of TLF for the Firehawk versus XIENCE stent. The incidence of very late definite or probable stent thrombosis was 0.8% in the Firehawk group and 1.4% in the XIENCE group (p=0.24).

Conclusions: The 3-year follow-up of the TARGET All Comers study showed comparable safety and efficacy profiles of the biodegradable polymer Firehawk and the durable polymer XIENCE stent.

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