Author + information
- Received July 22, 2015
- Revision received August 27, 2015
- Accepted September 10, 2015
- Published online January 11, 2016.
- Michael J. Lipinski, MD, PhD,
- Ricardo O. Escarcega, MD,
- Nevin C. Baker, DO,
- Hadiya A. Benn,
- Michael A. Gaglia Jr., MD, MSc,
- Rebecca Torguson, MPH and
- Ron Waksman, MD∗ ()
- ↵∗Reprint requests and correspondence:
Dr. Ron Waksman, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010.
Objectives The aim of this study was to determine the risk of scaffold thrombosis (ST) after percutaneous coronary intervention (PCI) with placement of an ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) by conducting a systematic review and meta-analysis.
Background PCI with BVS placement holds great potential, but concern has recently been raised regarding the risk of ST.
Methods MEDLINE/PubMed, Cochrane CENTRAL, and meeting abstracts were searched for all studies that included outcomes data for patients after PCI with BVS placement. For studies comparing BVSs with drug-eluting stents (DES), pooled estimates of outcomes, presented as odds ratios (ORs) with 95% confidence intervals (CIs), were generated with random-effects models.
Results Our analysis included 10,510 patients (8,351 with a BVS and 2,159 with DES) with a follow-up of 6.4 ± 5.1 months and 60 ± 11 years of age; 78% were male, 36% had stable angina, and 59% had acute coronary syndrome (ACS). Among patients with a BVS, cardiovascular death occurred in 0.6%, myocardial infarction (MI) in 2.1%, target lesion revascularization in 2.0%, and definite/probable ST in 1.2% of patients. Of BVS patients, 0.27% had acute ST and 0.57% had subacute ST. Meta-analysis demonstrated that patients who received a BVS were at a higher risk of MI (OR: 2.06, 95% CI: 1.31 to 3.22, p = 0.002) and definite/probable ST (OR: 2.06, 95% CI: 1.07 to 3.98, p = 0.03) compared with patients who received DES, whereas there was a trend toward decreased all-cause mortality with a BVS (OR: 0.40, 95% CI: 0.15 to 1.06, p = 0.06).
Conclusions Patients undergoing PCI with a BVS had increased definite/probable ST and MI during follow-up compared with DES. Further studies with long-term follow-up are needed to assess the risk of ST with a BVS.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 22, 2015.
- Revision received August 27, 2015.
- Accepted September 10, 2015.
- 2016 American College of Cardiology Foundation