Journal article

Late thrombotic events after bioresorbable scaffold implantation: a systematic review and meta-analysis of randomized clinical trials

  • Collet, Carlos Department of Cardiology, Academic Medical Center, Universiteit van Amsterdam, Netherlands
  • Asano, Taku Department of Cardiology, Academic Medical Center, Universiteit van Amsterdam, Netherlands
  • Miyazaki, Yosuke Department of Interventional Cardiology, Rotterdam, Netherlands
  • Tenekecioglu, Erhan Department of Interventional Cardiology, Rotterdam, Netherlands
  • Katagiri, Yuki Department of Cardiology, Academic Medical Center, Universiteit van Amsterdam, Netherlands
  • Sotomi, Yohei Department of Cardiology, Academic Medical Center, Universiteit van Amsterdam, Netherlands
  • Cavalcante, Rafael Department of Interventional Cardiology, Rotterdam, Netherlands
  • Winter, Robbert J. de Department of Cardiology, Academic Medical Center, Universiteit van Amsterdam, Netherlands
  • Kimura, Takeshi Department of Cardiovascular Medicine, Kyoto University Hospital, Shogoin Kawaharacho, Sakyo Ward, Kyoto, Japan
  • Gao, Runlin Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
  • Puricel, Serban Department of Cardiology, Fribourg University and Hospital, Fribourg, Switzerland
  • Cook, Stéphane Department of Cardiology, Fribourg University and Hospital, Fribourg, Switzerland
  • Capodanno, Davide Cardio-Thoracic-Vascular Department, Ferrarotto Hospital, University of Catania, Italy
  • Onuma, Yoshinobu Department of Interventional Cardiology, Rotterdam, Netherlands
  • Serruys, Patrick W. Imperial Department of Medicine, Imperial College of London, Kensington, London, UK
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    2017
Published in:
  • European Heart Journal. - 2017
English To compare the long-term safety and efficacy of bioresorbable vascular scaffold (BVS) with everolimus-eluting stent (EES) after percutaneous coronary interventions.Methods and Results: A systematic review and meta-analysis of randomized clinical trials comparing clinical outcomes of patients treated with BVS and EES with at least 24 months follow-up was performed. Adjusted random-effect model by the Knapp–Hartung method was used to compute odds ratios (OR) and 95% confidence intervals (CI). The primary safety outcome of interest was the risk of definite/probable device thrombosis (DT). The primary efficacy outcome of interest was the risk of target lesion failure (TLF). Five randomized clinical trials (n = 1730) were included. Patients treated with Absorb BVS had a higher risk of definite/probable DT compared with patients treated with EES (OR 2.93, 95%CI 1.37–6.26, P = 0.01). Very late DT (VLDT) occurred in 13 patients [12/996 (1.4%, 95%CI: 0.08–2.5) Absorb BVS vs. 1/701 (0.5%, 95%CI: 0.2–1.6) EES; OR 3.04; 95%CI 1.2–7.68, P = 0.03], 92% of the VLDT in the BVS group occurred in the absence of dual antiplatelet therapy (DAPT). Patients treated with Absorb BVS had a trend towards higher risk of TLF (OR 1.48, 95%CI 0.90–2.42, P = 0.09), driven by a higher risk of target vessel myocardial infarction and ischaemia-driven target lesion revascularization. No difference was found in the risk of cardiac death.Conclusion: Compared with EES, the use of Absorb BVS was associated with a higher rate of DT and a trend towards higher risk of TLF. VLDT occurred in 1.4% of the patients, the majority of these events occurred in the absence of DAPT.
Faculty
Faculté des sciences et de médecine
Department
Médecine 3ème année
Language
  • English
Classification
Clinical medicine
License
License undefined
Identifiers
Persistent URL
https://folia.unifr.ch/unifr/documents/305617
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