Long-term outcomes of bioresorbable vascular scaffold in ST-elevation myocardial infarction

Acta Cardiol. 2018 Jun;73(3):276-281. doi: 10.1080/00015385.2017.1380767. Epub 2017 Sep 28.

Abstract

Background: Bioresorbable vascular scaffolds (BVS) implantation in selected patients with stable angina has been demonstrated feasible and safe. However, limited data are currently available on long-term outcomes after BVS implantation for ST-elevation myocardial infarction (STEMI). Therefore, we sought to assess the safety, efficacy and long-term results of BVS implantation in STEMI patients.

Methods: Retrospective review of all STEMI patients treated with the Absorb® BVS (Abbott Vascular, Santa Clara, CA) or conventional drug eluting stent (DES) between 1 April 2013 and 30 March 2014. Primary outcomes were procedural success, device thrombosis and device-oriented composite endpoint (DOCE) including cardiac death, target vessel myocardial infarction and target lesion revascularization. The study included 54 BVS patients and 121 DES patients.

Results: Patients were slightly younger in the BVS group (60 vs. 63 years old, p = .03). Other baseline characteristics were comparable between the two groups. Procedural success was achieved in all patients. Median follow-up was 901 days and 849 days for BVS and DES patients, respectively (p = .01). The cumulative incidence of DOCE was not significantly different between the BVS and DES groups (7.5% vs. 9.1%, hazard ratio [HR]: 0.74 [95% confidence interval (CI): 0.26-2.2], p = NS). Rate of probable/definite device thrombosis were not statistically different between both groups (3.7% vs. 3.3%, p = NS).

Conclusions: The results of this single-centre retrospective study, one of the first assessing long-term safety and efficacy of BVS in STEMI, seems reassuring with similar long-term results as compared with patients treated with conventional DES.

Keywords: ABSORB; BVS; DES; ST-elevation myocardial infarction; STEMI; bioresorbable vascular scaffold; drug eluting stent.

MeSH terms

  • Absorbable Implants*
  • Aged
  • Coronary Angiography
  • Drug-Eluting Stents*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Prosthesis Design
  • Quebec / epidemiology
  • Retrospective Studies
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / surgery*
  • Time Factors
  • Tissue Scaffolds*
  • Treatment Outcome