Author + information
- Alok Saurav1,
- Aiman Smer1,
- Arun Kanmantha Reddy1,
- Venkata Mahesh Alla1,
- Manu Kaushik2,
- Claire C. Hunter1 and
- Aryan N. Mooss1
Recent randomized trials have raised concerns about the possibility of higher stent thrombosis (ST) with Bioabsorbable Vascular Scaffolds (BVS). We conducted this meta-analysis to further explore various types of ST rates with BVS in comparison to drug eluting stents (DES).
PubMed, Web of Science and Cochrane Library were searched through Nov 15th 2015 for relevant publications comparing BVS with DES. Primary outcome assessed was 'Definite ST' at 1 year (per ARC criteria). Secondary outcomes were sub-types of 'Definite ST' [acute(<1 day), sub acute(1-30days), late(30days -1year)], all cause death, cardiac death, myocardial infarction (MI), total and ischemia driven target vessel revascularization (TVR). Study quality, publication bias, heterogeneity were assessed. Analysis was done using DerSimonian Laird random effects method. Relative risk (RR) was used as the effect size.
5 randomized and 3 observational (2 with propensity matching) trials were (BVS: 2760, DES: 2212) selected. Mean age and gender distribution were similar between both groups. All patients were on dual antiplatelets for at least 1 year. A strong trend towards higher 'Definite ST' (RR 1.8 p=0.06) was seen with BVS although individual subtypes of 'Definite ST' [acute (RR 0.48 p=0.22); sub acute (RR 2.5 p=0.11); late (RR 1.4 p=0.61)] were similar between two groups. Clinical outcomes [death (RR 0.74 p=0.57); cardiac death (RR 0.83 p=0.66); TVR (RR 1.0 p = 0.95); ischemia driven TVR (RR 1.0 p=0.6)] were similar except for MI (RR 1.35 p=0.049), which was significantly higher with BVS.
Our meta-analysis showed higher occurrence of MI with a strong trend towards higher definite ST with BVS at 1 year.