August 30, 2023 — BIOFLOW-DAPT one-year-data demonstrated non-inferiority and a good safety profile for the Orsiro Missiondrug-eluting stent (DES) compared to Resolute Onyx DES (p<0.0001) in patients at high risk of bleeding receiving short dual antiplatelet therapy (DAPT). Prof. Marco Valgimigli presented the novel data in a late-breaking trial session at the European Society of Cardiology’s (ESC) Congress in Amsterdam. The results were published simultaneously in Circulation.
BIOFLOW-DAPT is a prospective, multi-center, international, two-arm randomized controlled clinical study to assess the safety of one-month DAPT in subjects with high bleeding risk. 1,948 patients were randomized 1:1 to percutaneous coronary intervention (PCI) with either Orsiro Mission or Resolute Onyx DES. Patients were treated with DAPT (aspirin and a P2Y12 inhibitor) for one month, followed by single antiplatelet therapy. Clinical follow-up visits were scheduled at one-, six- and 12-month post-procedure1.
The primary endpoint was a composite of cardiac death, myocardial infarction, and definite or probable stent thrombosis evaluated at 12 months. It was observed in 3.6% of the Orsiro Mission group and in 3.4% of the Resolute Onyx group (risk difference, 0.2 percentage points; upper boundary of the one-sided 95% confidence interval (CI), 1.8%; non-inferiority margin, 4.1%; p<0.0001 for non-inferiority).1
"Until recently the data on the performance of Orsiro stent in patients at high bleeding risk undergoing one-month DAPT was limited to observational studies," stated Prof. Dr. Marco Valgimigli, Deputy Chief of Interventional Cardiology at the Instituto Cardiocentro Ticino, Lugano, Switzerland. "The results show us that a PCI-strategy with biodegradable-polymer sirolimus-eluting stents like Orsiro Mission followed by 30 days of DAPT is non-inferior to durable-polymer zotarolimus-eluting stents in these patients."
Prolonged DAPT treatment increases the risk of bleeding after PCI. A reduction of bleeding after PCI is of major interest to patients as has a strong relationship with subsequent all-cause mortality and major adverse cardiovascular events.2
"Not only do the results add to the growing body of evidence within our extensive Orsiro DES family clinical program," said Prof. Dr. Georg Nollert, Vice President Medical Affairs, Vascular Intervention at BIOTRONIK. "They also suggest that one-month DAPT following PCI with Orsiro Mission DES can be considered a safe approach to reduce bleeding risks in these high-bleeding risk patients."
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References:
1. Valgimigli, M. BIOFLOW DAPT - Biodegradable polymer SES versus durable polymer ZES in HBR subjects with 1-month DAPT. Presented at: ESC Congress 2023. August 25, 2023.
2. Safety of 3‐Month Dual Antiplatelet Therapy After Implantation of Ultrathin Sirolimus‐Eluting Stents With Biodegradable Polymer (Orsiro): Results From the SMART‐CHOICE Trial, Journal of the American Heart Association. 2021;10:e018366
June 11, 2025 
