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) - Goel, Sunny
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.