Abstract
BackgroundCoronary bioresorbable scaffolds (BRS) were developed to overcome the limitations of standard metallic stents, especially to address late events after percutaneous coronary interventions. The aim of this meta-analysis was to evaluate the efficacy and safety of BRS, compared with Everolimus-eluting stents (EES), using the data available from randomized trials, with a focus on long-term outcomes.MethodsPublished randomized trials comparing BRS to EES for the treatment of coronary artery disease were searched for within PubMed, Cochrane Library and Scopus electronic databases up to April 4th 2017. The summary measure used was odds ratio (OR) with 95% confidence intervals.ResultsA total of 5 studies were eligible, including 5219 patients. At 2 years, BRS was associated with higher rates of target lesion failure (9.4% vs 7.2%; OR = 1.33; 95% CI 1.07 to 1.63; p = 0.008) and device thrombosis (2.3% vs 0.7%; OR = 3.22; 95% CI 1.86 to 5.57; p < 0.0001) compared with EES. The incidence of both early (within 30 days after implantation, 1.1% vs 0.5%, OR 1.97, 95% CI 1.02 to 3.81; p = 0.05) and very-late device thrombosis (>1 year, 0.6% vs 0.1%, OR 4.03, 95% CI 1.37 to 11.82; p = 0.01) was higher with BRS compared with EES.ConclusionsBRS may be associated with worse two-years clinical outcomes compared with EES in patients with coronary artery disease.
Highlights
Coronary bioresorbable scaffolds (BRS) were developed to overcome the limitations of standard metallic stents, especially to address late events after percutaneous coronary interventions
BRS may be associated with worse two-years clinical outcomes compared with eluting stents (EES) in patients with coronary artery disease
Studies were considered eligible if the following statements were applying: a) they involved a study population with coronary artery disease; b) multicenter randomized controlled trials c) they compared BRS versus EES; d) follow-up length of 2 years; e) they reported outcome data: target lesion failure (TLF), device thrombosis (DvT), cardiac death, target-vessel myocardial infarction (TVMI), ischemia-driven target lesion revascularization (ID-TLR); f) minimum of 100 patients treated with BRS
Summary
Published randomized trials comparing BRS to EES for the treatment of coronary artery disease were searched for within PubMed, Cochrane Library and Scopus electronic databases up to April 4th 2017. The summary measure used was odds ratio (OR) with 95% confidence intervals
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