One‐year clinical performance of ABSORB bioresorbable vascular scaffold in patients presenting with acute coronary syndromes: Results from the RAI registry

Abstract

Objectives To report 1‐year clinical outcomes of bioresorbable vascular scaffold (BVS) in acute coronary syndromes (ACS) population. Background BVS use has rapidly extended to high‐risk patients as those presenting with ACS. To date limited data have been reported on BVS performance in ACS patients. Methods RAI is a multicenter, prospective registry that included 1,505 patients treated with at least 1 successful BVS implantation. A subgroup analysis on ACS patients was performed and the 1‐year outcomes of this cohort compared to the remaining stable coronary artery disease (SCAD) population are reported here. Coprimary endpoints were target‐lesion revascularization (TLR) and scaffold thrombosis (ScT) at 1‐year follow‐up. Results Fifty‐nine percent of the patients presented with ACS, of whom 36.5% with ST‐elevation myocardial infarctions. ACS patients were significantly younger, with a better cardiovascular risk profile, a lower rate of multivessel disease, chronic total occlusion or in‐stent restenosis and a lower Syntax score. Predilation and postdilation were performed in 97.4% and in 96.5% of cases, respectively. No differences were noted in terms of TIMI 3 final flow, but acute gain was greater in ACS compared to SCAD group (P < 0.001). At one‐year follow‐up no differences were found in terms of TLR (3.3% vs. 3.3%, P = 0.98), and device‐oriented composite end‐point (4.3% vs. 3.4%, P = 0.4) between ACS and SCAD groups. The rate of definite/probable ScT was numerically higher in ACS vs. stable CAD patients (1.3% vs. 0.8%, P = 0.2). Conclusions Our data suggest that the use of BVS in ACS patients is associated with a numerically higher rate of ScT compared to SCAD population numerically higher, but without statistical significance.

Three-year results of ST-segment elevation myocardial infarction patients treated with a prespecified bioresorbable vascular scaffold implantation strategy: bVS STEMI STRATEGY-IT long-term

“…BVS data in STEMI are limited to registries, 18–22 propensity score matching 8,23 or meta-analysis 24 . Only two randomized trials 7,25,26 compared Absorb with EES in STEMI, showing similar 3-year outcomes 27 but better vasomotion response in BVS patients 28 .…”

“…12 However, the high thrombogenic milieu of STEMI increases the risk of stent thrombosis and even DES were contraindicated before the demonstration of their safety and efficacy. [13][14][15][16][17] BVS data in STEMI are limited to registries, [18][19][20][21][22] propensity score matching 8,23 or meta-analysis. 24 Only two randomized trials 7,25,26 compared Absorb with EES in STEMI, showing similar 3-year outcomes 27 but better vasomotion response in BVS patients.…”