Three to four years outcomes of the absorb bioresorbable vascular scaffold versus second‐generation drug‐eluting stent: A meta‐analysis. Issue 2 (19th April 2019)

• Record Type: Journal Article
• Authors: Goel, Sunny; Pasam, Ravi Teja; Chava, Srilekha; Sharma, Abhishek; Malik, Bilal Ahmad; Ayzenberg, Sergey; Frankel, Robert; Shani, Jacob; Gidwani, Umesh
• Is Part Of: Catheterization and cardiovascular interventions. Volume 95:Issue 2(2020)
• Page Start: 216
• Page End: 223
• Publication Date: 2019-04-19
• Subjects: absorb -- bioresorbable vascular scaffolds -- clinical outcomes -- drug‐eluting stents; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.28290
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objective: This meta‐analysis sought to evaluate the outcomes of absorb bioresorbable vascular scaffolds (BVS) compared with second‐generation drug‐eluting stents (DES) after 3 years, the approximate time of complete polymer bioresorption. Background: BVS were found to be inferior to second‐generation DES in early and mid‐term outcomes with a higher rate of target vessel myocardial infarction (TV‐MI) and device thrombosis (DT). Improper implantation techniques and incomplete bioresorption of the poly‐l ‐lactide (PLLA) polymer were sighted as possible reasons. Methods: We conducted an electronic database search for all randomized control trials that compared absorb BVS to second‐generation DES and reported outcomes of interest after 3 years of absorb BVS implantation. Assuming interstudy heterogeneity, a random‐effects analysis was conducted with odds ratio as the effect size of choice to compare the event rates between the two groups. Results: A total of four studies ( n = 3, 245, BVS = 2075, DES = 1, 170) were included in the final analysis. Pooled analysis revealed that there was no difference between absorb BVS and second‐generation DES with respect to target lesion failure (TLF) (OR = 1.23, 95% CI = 0.73–2.07, p = 0.44), TV‐MI (OR = 1.03, 95% CI = 0.42–2.53, p = 0.95), target lesion revascularization (TLR) (OR = 1.61, 95% CI = 0.77–3.33, p = 0.20) and definite/probable DT (OR = 0.71, 95% CI = 0.10–5.07, p = 0.74). Also, there was no difference in cardiac mortality (OR = 0.66, 95% CI = 0.22–1.94, p = 0.45). Conclusions: Between 3 and 4 years of follow‐up, patients receiving absorb BVS did not have significantly different outcomes, in terms of TLF, TV‐MI, TLR, DT, and cardiac mortality, compared to DES.