Abstract

BACKGROUND: Safety and efficacy of bioresorbable vascular scaffolds (BRS) and the role of postdilatation on outcome in acute coronary syndrome (ACS) patients compared with those of everolimus-eluting stents (EES) remain unknown. The aim of the study is to compare the safety and efficacy of BRS with EES in ACS and to investigate the role of BRS postdilatation.
METHODS: Consecutive ACS patients undergoing BRS implantation in 8 centers were com­pared with those with EES before and after propensity score matching. Major adverse cardiac event (MACE), myocardial infarction, and target lesion revascularization (TLR) were the primary endpoint. Sensitivity analysis was performed according to postdilatation after BRS implantation. We enrolled 303 BRS and 748 EES patients; 215 from each group were com­pared after matching, and 117 (55.2%) BRS patients were treated with postdilatation.
RESULTS: After a median follow-up of 24.0 months, MACE rates were higher in BRS patients than in EES patients (9.3% vs. 4.7%, p < 0.001), mainly driven by TLR (6.1% vs. 1.9%, p < 0.001). Stent thrombosis increased in the BRS group (2.8% vs. 0.9%, p = 0.01). How­ever, after sensitivity analysis, MACE rates in BRS patients with postdilatation were signifi­cantly lower than in those without, comparable to EES patients (6.0% vs. 12.6% vs. 4.7%, p < 0.001). The same trend was observed for TLR (3.4% vs. 8.4% vs. 1.9%, p < 0.001). Stent thrombosis rates were higher in both the BRS groups than in EES patients (2.6% vs. 3.2% vs. 0.9%, p = 0.045).
CONCLUSIONS: Postdilatation appears effective when using BRS in ACS patients. MACE rates are comparable to those of EES, although scaffold thrombosis is not negligible. Randomized prospective studies are required for further investigation.

Details

Title
Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry
Author
Imori, Yoichi 1 ; D'Ascenzo, Fabrizio 2 ; Gori, Tommaso 3 ; Münzel, Thomas 3 ; Ugo, Fabrizio 4 ; Campo, Gianluca 5 ; Cerrato, Enrico 6 ; Napp, L. Christian 7 ; Iannaccone, Mario 2 ; Ghadri, Jelena R. 1 ; Kazemian, Elycia 1 ; Binder, Ronald K. 1 ; Jaguszewski, Milosz 1 ; Csordas, Adam 1 ; Capasso, Piera 4 ; Biscaglia, Simone 5 ; Conrotto, Fedrico 2 ; Varbella, Ferdinando 6 ; Garbo, Roberto 4 ; Gaita, Fiorenzo 2 ; Erne, Paul 8 ; Lüscher, Thomas F. 1 ; Moretti, Claudio 2 ; Frangieh, Antonio H. 1 ; Templin, Christian 9 

 University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland 
 Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy 
 Medizinische Klinik und Poliklinik-Kardiologie, Angiologie und Internistische Intensivmedizin, University Medical Center, Mainz, Germany 
 Interventional Cardiology Department, San Giovanni Bosco Hospital, Turin, Italy 
 Cardiovascular Institute, Azienda Ospedaliero-Universitaria S. Anna, Cona, FE, Italy; Laboratorio per le Tecnologie delle Terapie Avanzate (LTTA) Center, Ferrara, Italy 
 Cardiology Department, Ospedale degli Infermi, Rivoli TO, Italy 
 Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany 
 Heart Centre Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland 
 University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland. [email protected] 
First page
374
End page
383
Publication year
2016
Publication date
2016
Publisher
Wydawnictwo Via Medica
ISSN
18975593
e-ISSN
1898018X
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2464206215
Copyright
© 2016. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.