Exploring reasons for different bioresorbable scaffolds outcomes in women versus men: The research must go on

Abstract

Bioresorbable scaffolds (BRS) have been developed to theoretically guarantee an efficacy similar to permanent drug-eluting stents (DES) with additional late benefits related to restoration of vessel structure and function [ [1] Jinnouchi H. Torii S. Sakamoto A. Kolodgie F.D. Virmani R. Finn A.V. Fully bioresorbable vascular scaffolds: lessons learned and future directions. Nat. Rev. Cardiol. 2019; 16: 286-304 Crossref PubMed Scopus (82) Google Scholar ]. However, promises of BRS have not been met with Absorb, a first-generation device with the broadest clinical evidence showing increased thrombotic risk vs. DES [ [1] Jinnouchi H. Torii S. Sakamoto A. Kolodgie F.D. Virmani R. Finn A.V. Fully bioresorbable vascular scaffolds: lessons learned and future directions. Nat. Rev. Cardiol. 2019; 16: 286-304 Crossref PubMed Scopus (82) Google Scholar ]. These disappointing results have dampened the BRS use but have prompted the development of new-generation BRS and have fuelled the research of possible clinical, angiographic and procedural predictors of scaffold thrombosis [ [1] Jinnouchi H. Torii S. Sakamoto A. Kolodgie F.D. Virmani R. Finn A.V. Fully bioresorbable vascular scaffolds: lessons learned and future directions. Nat. Rev. Cardiol. 2019; 16: 286-304 Crossref PubMed Scopus (82) Google Scholar ]. The impact of patients' genders on BRS performance has been also explored [ [2] Baquet M. Hoppmann P. Grundmann D. Schmidt W. Kufner S. Theiss H.D. et al. Sex and long-term outcomes after implantation of the Absorb bioresorbable vascular scaffold for treatment of coronary artery disease. EuroIntervention. 2019; 15: 615-622 Crossref PubMed Scopus (5) Google Scholar ]. A paradox in sex-specific clinical outcomes after bioresorbable scaffold implantation: 2-year results from the AIDA trialInternational Journal of CardiologyVol. 300PreviewFemales are underrepresented in clinical trials evaluating new stent technologies whilst results may differ between the sexes. Females are known to have smaller, more tortuous coronary arteries and have generally more comorbidities. On the other hand, they may have smaller plaque burden. This subgroup-analysis sought to assess sex-specific outcomes after Absorb bioresorbable vascular scaffold (BVS) or XIENCE everolimus-eluting stent (EES) implantation. Full-Text PDF Open Access