Biodegradable-polymer versus durable-polymer drug-eluting stents in left main percutaneous coronary intervention: final results of the randomised IDEAL-LM trial

The optimal strategy for patients with left main (LM) coronary disease and an indication for revascularisation is uncertain. Previous studies, including the EXCEL and NOBLE trials, have shown that percutaneous coronary intervention (PCI) is an acceptable alternative to coronary artery bypass graft (CABG) surgery, with comparable outcomes. However, the optimal PCI strategy has yet to be determined12. The IDEAL-LM trial randomised 818 patients undergoing LM PCI in a 1:1 ratio to treatment with either a durable-polymer (DP) drug-eluting stent (DES) and 12 months of dual antiplatelet therapy (DAPT) or a biodegradable-polymer (BP) DES with 4 months of DAPT. After 2 years of follow-up, clinical outcomes were similar in both groups3. Here, we report the final 5-year outcomes.

In brief, the IDEAL-LM trial was an investigator-initiated, international, multicentre, open-label, randomised clinical trial. The primary objective was to establish non-inferiority of the BP platinum-chromium everolimus-eluting stent (BP-PtCr-EES; SYNERGY [Boston Scientific]) group to the DP cobalt- chromium everolimus-eluting stent (DP-CoCr-EES; XIENCE [Abbott]) group for the composite endpoint of major adverse cardiovascular events (MACE) − defined as all-cause death, myocardial infarction (MI),...