Clinical outcomes of bioresorbable vascular scaffold to treat all-comer patients. Are patients with acute coronary syndrome better candidates for bioresorbable vascular scaffold?

Picard, Fabien; Avram, Robert; Marquis‐Gravel, Guillaume; Tadros, Victor-Xavier; Ly, Hung Q.; Dorval, Jean-François; Doucet, Serge; Gosselin, Gilbert; Asgar, Anita W.; Ibrahim, Réda; Bonan, Raoul; Hemptinne, Quentin de; Nosair, Mohamed; L-L'allier, Philippe; Tanguay, Jean‐François

doi:10.1016/j.carrev.2018.06.022

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…Interestingly, several studies 17,18 and real world data 19 20 However, further analysis of our data suggested that the lower event rates observed in STEMI may be driven by patient characteristics, including less diffuse coronary artery disease.…”

Section: Discussionmentioning

confidence: 58%

“…Interestingly, several studies 17,18 and real world data 19 suggest that patients with STEMI show lower complication rates than other patients when treated with BVS. Indeed, a subgroup analysis of our cohort confirms that 2‐year MACE (8.1% vs. 11.4%, p = 0.05), target vessel failure (TVF) (7.0% vs. 10.8%, p < 0.05) and TVR (6.8% vs. 10.2%, p < 0.05) were significantly less frequent in patients with STEMI compared to patients with stable CAD in unadjusted analyses.…”

Section: Discussionmentioning

confidence: 99%

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Everolimus eluting bioresorbable vascular scaffolds in patients with acute coronary syndromes: Two‐year results from the German‐Austrian ABSORB registry

Tröbs

Achenbach

Nef

et al. 2021

Catheter Cardiovasc Interv

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Objectives To identify potential differences in 2‐year outcome between patients who underwent coronary revascularization using bioresorbable vascular scafffolds (BVS) in stable coronary artery disease (CAD) and acute coronary syndromes (ACS). Background Data from randomized trials suggest a significantly higher event rate following coronary revascularization using everolimus‐eluting BVS as compared to new generation drug eluting stents. Whether particular patient subgroups are at increased risk for scaffold thrombosis and target lesion failure (TLF) has not clearly been demonstrated. Methods German‐Austrian ABSORB RegIstRy is a prospective all‐comer multi‐center observational study of consecutive patients who were considered for coronary revascularization with BVS. We compared 1499 patients with stable CAD to 1594 patients with ACS. Endpoints were major adverse cardiac events (MACE), TLF, and scaffold thrombosis. Results While single vessel disease was more prevalent in ACS (46% vs. 37%, p < 0.0001), lesion complexity (B2/C stenosis 37% vs. 36%, bifurcation 2.4% vs. 3.4%, p < 0.05), number of implanted scaffolds/patient (1.34 vs. 1.43), scaffold length (18 vs. 18 mm) or the rate of high pressure postdilatation (68% vs. 70%) did not differ between ACS and stable CAD. Two‐year MACE rates were 11.6% in ACS and 11.4% in stable CAD, TLF occurred in 7.0% versus 7.4% and target vessel revascularization in 8.8 versus 10.2% (n.s. for all). Definite scaffold thrombosis rates were not significantly different (ACS 1.9% vs. stable CAD 2.1%). Conclusion Real‐world 2‐year event rates after coronary revascularization with BVS are not significantly different between individuals with ACS as compared to stable CAD.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Everolimus eluting bioresorbable vascular scaffolds in patients with acute coronary syndromes: Two‐year results from the German‐Austrian ABSORB registry

Tröbs

Achenbach

Nef

et al. 2021

Catheter Cardiovasc Interv

View full text Add to dashboard Cite

show abstract

“…The incidence of MACE in the EROSION study was 3.6% at 1‐month follow‐up, 7.5% at 1‐year follow‐up, and 23.1% at 4‐year follow‐up. 6 , 7 Previous studies have reported that the incidence of MACE in patients with ACS after stent treatment is 3% to 6% at 1 month, 15 , 16 6% to 9% at 1 year, 15 , 17 11% to 12% at 2 years, 18 , 19 and 13% at 3 years, 20 , 21 which is lower compared with that in the EROSION study, but this is because none of these studies included rehospitalization because of unstable or progressive angina as MACE. The proportion of these patients is 15.5% in our study.…”

Section: Discussionmentioning

confidence: 83%

Predictors of Adverse Prognosis in Patients With Acute Coronary Syndrome Caused by Plaque Erosion With a Nonstent Strategy

Yin

Lei

Fang

et al. 2022

JAHA

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Background The EROSION (Effective Anti‐Thrombotic Therapy Without Stenting: Intravascular Optical Coherence Tomography‐Based Management in Plaque Erosion) study demonstrated that antithrombotic therapy without stenting was safe and feasible in selected patients with acute coronary syndrome caused by plaque erosion. However, the factors related to the prognosis of these patients are not clear. This study aimed to explore the predictors of an adverse prognosis of a nonstent strategy in a larger sample size. Methods and Results A total of 252 (55 patients were from the EROSION study) patients with acute coronary syndrome with plaque erosion who met the inclusion criteria of the EROSION study and completed clinical follow‐up were enrolled. Patients were divided into 2 groups according to the occurrence of major adverse cardiovascular events (MACE), which were defined as the composite of cardiac death, recurrent myocardial infarction, ischemia‐driven target lesion revascularization, rehospitalization because of unstable or progressive angina, major bleeding, and stroke. Among 232 patients with acute coronary syndrome included in the final analysis, 50 patients (21.6%) developed MACE at a median follow‐up of 2.9 years. Compared with patients without MACE, patients with MACE were older and had a higher degree of percentage of area stenosis (72.2%±9.4% versus 64.2%±15.7%, P <0.001) and thrombus burden (24.4%±10.4% versus 20.4%±10.9%, P =0.010) at baseline. Multivariate Cox regression analysis confirmed that age, percentage of area stenosis, and thrombus burden were predictors of MACE. The best cutoff values of predictors were age ≥60 years, percentage of area stenosis ≥63.5%, and thrombus burden ≥18.5%, respectively, and when they were all present, the rate of MACE rose to 57.7%. Conclusions The nonstent treatment strategy of patients with acute coronary syndrome caused by plaque erosion was heterogeneous, and patients aged ≥60 years, percentage of area stenosis ≥63.5%, and thrombus burden ≥18.5% may predict a worse clinical outcome.

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Clinical outcomes of bioresorbable vascular scaffold to treat all-comer patients. Are patients with acute coronary syndrome better candidates for bioresorbable vascular scaffold?

Cited by 2 publications

References 18 publications

Everolimus eluting bioresorbable vascular scaffolds in patients with acute coronary syndromes: Two‐year results from the German‐Austrian ABSORB registry

Everolimus eluting bioresorbable vascular scaffolds in patients with acute coronary syndromes: Two‐year results from the German‐Austrian ABSORB registry

Predictors of Adverse Prognosis in Patients With Acute Coronary Syndrome Caused by Plaque Erosion With a Nonstent Strategy

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