Coronary disease & ACS

Bioadaptor implant versus contemporary drug-eluting stent in percutaneous coronary interventions in Sweden (INFINITY-SWEDEHEART): a single-blind, non-inferiority, registry-based, randomised controlled trial

LancetPublished Randomised controlled trial

Primary result · Target lesion failureResult — go to the resultRisk difference −0.41% 95% CI −1.94 to 1.11

Authors' conclusion

Among patients with coronary artery disease, including those with acute coronary syndrome, treatment with the bioadaptor was non-inferior to contemporary DES, showing potential to mitigate non-plateauing device-related events and improving outcomes in patients undergoing PCI.

Study context

Population
Patients aged 18–85 years with chronic or acute coronary syndrome, indication for percutaneous coronary intervention (PCI), up to three de novo lesions, SwedenITT population
Participants
2,399 patients
Comparison
DynamX bioadaptor vs zotarolimus-eluting drug-eluting stent (DES)
  • Bioadaptorn = 1,201
  • DESn = 1,198reference
Primary endpoint
Target lesion failure:
  • CV death
  • Target vessel MI
  • Ischaemia-driven target lesion revascularisation
Follow-up
Up to 12 months
Methodological detailssingle-blind, non-inferiority, registry-based, 20 hospitals in Sweden
  • Single-blind
  • Non-inferiority
  • Registry-based
  • 20 hospitals in Sweden

Primary result

Target lesion failure

Risk difference

−0.41%

95% CI −1.94 to 1.11

P < 0.0001 for non-inferiority

Events by treatment group

Bioadaptorvs DES
risk difference −0.41% (95% CI −1.94 to 1.11); P for non-inferiority < 0.0001

As reported in the abstract

Secondary outcomes

OutcomeBioadaptorDESHR (95% CI)P value
Target lesion failure, landmark 6–12 monthsKaplan-Meier estimates0.3%1.7%0.19 (0.06–0.65)P = 0.0079
Target vessel failure, landmark 6–12 months0.8%2.5%0.35 (0.16–0.79)P = 0.011
Target lesion failure in ACS, landmark 6–12 months0.3%1.8%0.17 (0.04–0.74)P = 0.018

Safety

OutcomeBioadaptorDESDifference in event rates (95% CI)
Definite or probable device thrombosis0.7%0.5%0.16% (−0.50 to 0.83)

Original publication

Bioadaptor implant versus contemporary drug-eluting stent in percutaneous coronary interventions in Sweden (INFINITY-SWEDEHEART): a single-blind, non-inferiority, registry-based, randomised controlled trial. Lancet. Published 28 October 2024. doi:10.1016/s0140-6736(24)02227-x

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