ObjectivesWe aimed to compare the long-term outcomes of the novel biodegradable polymer cobalt-chromium sirolimus-eluting stent (BP-SES) versus the durable polymer sirolimus-eluting stent (DP-SES) in the I-LOVE-IT2 trial. BackgroundsComparisons of the long-term safety and efficiency of the BP-DES versus the DP-DES are limited. MethodsA total of 2,737 patients eligible for coronary stenting were randomized to the BP-SES or DP-SES group at a 2:1 ratio. The primary endpoint of target lesion failure (TLF) was defined as a composite of cardiac death, target vessel myocardial infarction (MI), or clinically indicated target lesion revascularization. ResultsA three-year clinical follow-up period was available for 2,663 (97.3%) patients. There were no significant differences in TLF (8.9% vs. 8.6%, P=0.81), patient-oriented composite endpoint (PoCE) (15.2% vs.14.5%, P=0.63), or individual components between the BP-SES and DP-SES. Definite/probable stent thrombosis (ST) was low and similar at 3 years (0.8% vs. 1.0%, P=0.64). Landmark analysis of 1-3 years showed that the TLF (2.7% vs. 2.6%, P=0.81), PoCE (6.2% vs. 5.1%, P=0.28), and definite/probable ST (0.4% vs. 0.4%, P=1.00) were comparable between the 2 arms. ConclusionsIn this prospective randomized trial, the BP-SES showed similar clinical results versus the DP-SES in terms of safety and efficacy outcomes over a 3-year follow-up period.