Key result
At 1-year follow-up, there was no significant difference in the rate of device-oriented composite endpoint between patients with acute myocardial infarction treated with bioresorbable scaffolds and those treated with durable polymer everolimus-eluting metallic stents (HR 0.43).
Why the study?
Clinical outcomes comparing bioresorbable scaffolds to durable polymer everolimus-eluting metallic stents in patients with acute myocardial infarction undergoing successful PCI needed evaluation.
Does everolimus-eluting bioresorbable scaffolds (BRS) reduce device-oriented composite endpoint compared to durable polymer everolimus-eluting metallic stents (DP-EES) in patients with acute myocardial infarction undergoing successful PCI?
Observational (n=952)
Yes
Does everolimus-eluting bioresorbable scaffolds (BRS) reduce device-oriented composite endpoint compared to durable polymer everolimus-eluting metallic stents (DP-EES) in patients with acute myocardial infarction undergoing successful PCI?
Hazard Ratio: 0.43 (95% CI 0.13–1.41)
Absolute Event Rate: 2.2% vs 4.8%
p-value: p=0.163
In patients with acute myocardial infarction, bioresorbable scaffolds showed comparable 1-year efficacy and safety to durable polymer everolimus-eluting metallic stents, suggesting they may be a reasonable strategy in young, low-risk patients when guided by intravascular imaging.
BACKGROUND AND OBJECTIVES: This study sought to compare clinical outcomes between bioresorbable scaffolds (BRS) and durable polymer everolimus-eluting metallic stents (DP-EES) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI). METHODS: From March 2016 to October 2017, 952 patients with AMI without cardiogenic shock undergoing successful PCI with BRS (n = 136) or DP-EES (n = 816) were enrolled from a multicenter, observational Korea Acute Myocardial Infarction Registry. RESULTS: In the crude population, there was no significant difference in the 1-year rate of device-oriented composite endpoint (DOCE) and device thrombosis between the BRS and DP-EES groups (2.2% vs. 4.8%, hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.13-1.41, p = 0.163; 0.7% vs. 0.5%, HR 1.49, 95% CI 0.16-13.4, p = 0.719, respectively). BRS implantation was opted in younger patients (53.7 vs. 62.6 years, p < 0.001) with low-risk profiles, and intravascular image-guided PCI was more preferred in the BRS group (60.3% vs. 27.2%, p < 0.001). CONCLUSIONS: At 1-year follow-up, no differences in the rate of DOCE and device thrombosis were observed between patients with AMI treated with BRS and those treated with DP-EES. Our data suggest that imaging-guided BRS implantation in young patients with low risk profiles could be a reasonable strategy in the setting of AMI.
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Kim et al. (2020) conducted an observational in Acute myocardial infarction (n=952). Bioresorbable scaffolds (BRS) vs. Durable polymer everolimus-eluting metallic stents (DP-EES) was evaluated on Device-oriented composite endpoint (DOCE) including cardiac death, target vessel myocardial infarction, and ischemic-driven target lesion revascularization at 1 year (HR 0.43, 95% CI 0.13-1.41, p=0.163). At 1-year follow-up, there was no significant difference in the rate of device-oriented composite endpoint between patients with acute myocardial infarction treated with bioresorbable scaffolds and those treated with durable polymer everolimus-eluting metallic stents (HR 0.43).
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