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Peer-reviewedCC BY-NC-ND 4.0Coronary Artery Disease

Comparative effectiveness of Orsiro, Xience, Synergy, and Resolute stent in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a nationwide registry study

  • Hyun Woong Park1
  • Yong Kyun Kim2
  • Seok-Woo Seong1
  • Jae-Hwan Lee1
  • Mi Joo Kim1
  • Pil Sang Song1
  • Seon-Ah Jin1
  • Kye Taek Ahn1
  • Youngkeun Ahn3
  • Sang Hyun Park4
  • Jin-Yong Hwang5
  • Chang-Hwan Yoon6
1 more authors
  • Jin-Ok Jeong1
6 affiliations
  1. 1Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon
  2. 2Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Chungnam National University Sejong Hospital, Sejong
  3. 3Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju
  4. 4Department of Internal Medicine and Cardiovascular Center, Daejeon Eulji University Hospital, Daejeon
  5. 5Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju
  6. 6Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea
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Abstract

Background: Head-to-head comparisons of contemporary drug-eluting stents (DES) in patients with acute myocardial infarction (AMI) remain limited. We sought to compare the long-term clinical outcomes of four widely used DES platforms: Orsiro, Xience, Synergy, and Resolute.

Methods: From the nationwide prospective Korea acute myocardial infarction registry-V, we identified 9284 patients with AMI undergoing percutaneous coronary intervention with one of the four study devices (Orsiro, n = 1634; Xience, n = 2576; Synergy, n = 2811; Resolute, n = 2263). The primary endpoint was target lesion revascularization (TLR). Inverse probability of treatment weighting was performed to adjust for baseline differences.

Results: During a median follow-up of 723 days, the cumulative incidence of TLR differed significantly among groups. In IPTW-adjusted analyses, compared with the Orsiro group (reference), the risk of TLR was significantly higher in the Synergy [hazard ratio: 2.30; 95% confidence interval (CI): 1.20–4.41, P = 0.013] and Resolute groups (hazard ratio: 2.30, 95% CI: 1.18–4.47, P = 0.014). The Xience group showed a comparable risk of TLR to Orsiro (hazard ratio: 1.40, 95% CI: 0.69–2.82, P = 0.346). Target vessel revascularization followed a similar pattern, favoring Orsiro. However, there were no significant differences in composite major adverse cardiovascular events or all-cause mortality among the four groups.

Conclusion: In this large-scale, real-world AMI cohort, the ultrathin-strut, biodegradable-polymer Orsiro stent was associated with a lower risk of repeat revascularization compared with the Synergy and Resolute stents. Xience demonstrated comparable outcomes to Orsiro. Stent selection remains a crucial determinant of vessel-level outcomes in patients with AMI.

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Cite

BibTeXRIS
BibTeX
@article{park2026comparative,
  title = {{Comparative effectiveness of Orsiro, Xience, Synergy, and Resolute stent in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a nationwide registry study}},
  author = {Hyun Woong Park and Yong Kyun Kim and Seok-Woo Seong and Jae-Hwan Lee and Mi Joo Kim and Pil Sang Song and Seon-Ah Jin and Kye Taek Ahn and Youngkeun Ahn and Sang Hyun Park and Jin-Yong Hwang and Chang-Hwan Yoon and Jin-Ok Jeong},
  journal = {Coronary Artery Disease},
  year = {2026},
  month = jun,
  doi = {10.1097/mca.0000000000001659},
  url = {https://doi.org/10.1097/mca.0000000000001659},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Comparative effectiveness of Orsiro, Xience, Synergy, and Resolute stent in patients with acute myocardial infarction undergoing percutaneous coronary intervention: a nationwide registry study
AU  - Hyun Woong Park
AU  - Yong Kyun Kim
AU  - Seok-Woo Seong
AU  - Jae-Hwan Lee
AU  - Mi Joo Kim
AU  - Pil Sang Song
AU  - Seon-Ah Jin
AU  - Kye Taek Ahn
AU  - Youngkeun Ahn
AU  - Sang Hyun Park
AU  - Jin-Yong Hwang
AU  - Chang-Hwan Yoon
AU  - Jin-Ok Jeong
PY  - 2026
DA  - 2026/06/19
JO  - Coronary Artery Disease
DO  - 10.1097/mca.0000000000001659
UR  - https://doi.org/10.1097/mca.0000000000001659
AB  - Background: Head-to-head comparisons of contemporary drug-eluting stents (DES) in patients with acute myocardial infarction (AMI) remain limited. We sought to compare the long-term clinical outcomes of four widely used DES platforms: Orsiro, Xience, Synergy, and Resolute.  Methods: From the nationwide prospective Korea acute myocardial infarction registry-V, we identified 9284 patients with AMI undergoing percutaneous coronary intervention with one of the four study devices (Orsiro, n = 1634; Xience, n = 2576; Synergy, n = 2811; Resolute, n = 2263). The primary endpoint was target lesion revascularization (TLR). Inverse probability of treatment weighting was performed to adjust for baseline differences.  Results: During a median follow-up of 723 days, the cumulative incidence of TLR differed significantly among groups. In IPTW-adjusted analyses, compared with the Orsiro group (reference), the risk of TLR was significantly higher in the Synergy [hazard ratio: 2.30; 95% confidence interval (CI): 1.20–4.41, P = 0.013] and Resolute groups (hazard ratio: 2.30, 95% CI: 1.18–4.47, P = 0.014). The Xience group showed a comparable risk of TLR to Orsiro (hazard ratio: 1.40, 95% CI: 0.69–2.82, P = 0.346). Target vessel revascularization followed a similar pattern, favoring Orsiro. However, there were no significant differences in composite major adverse cardiovascular events or all-cause mortality among the four groups.  Conclusion: In this large-scale, real-world AMI cohort, the ultrathin-strut, biodegradable-polymer Orsiro stent was associated with a lower risk of repeat revascularization compared with the Synergy and Resolute stents. Xience demonstrated comparable outcomes to Orsiro. Stent selection remains a crucial determinant of vessel-level outcomes in patients with AMI.
SN  - 0954-6928
SN  - 1473-5830
ER  -