Key result
ACS presentation is not associated with higher scaffold thrombosis rates after BVS implantation.
Why the study?
Patients with ACS had a higher risk of early stent thrombosis in the DES era, but it was unclear if this applies to bioresorbable vascular scaffolds.
Does the proportion of patients with acute coronary syndrome impact the incidence of scaffold thrombosis after bioresorbable vascular scaffold implantation?
Meta-Analysis (n=13,708)
Yes
Does the proportion of patients with acute coronary syndrome impact the incidence of scaffold thrombosis after bioresorbable vascular scaffold implantation?
Effect estimate: R2=0.030
p-value: p=0.255
The proportion of patients with acute coronary syndrome does not appear to significantly impact the incidence of scaffold thrombosis after bioresorbable vascular scaffold implantation.
BVS shows no ACS-related increase in scaffold thrombosis; challenges DES-era patterns but leaves clinical adoption open pending randomized confirmation.
AIMS: In the drug-eluting stent (DES) era, patients with acute coronary syndrome (ACS) had a higher risk of early stent thrombosis compared with stable patients. The present study aimed to evaluate whether the same is true for the bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, CA, USA). METHODS AND RESULTS: We assessed the relationship between the incidence of definite/probable scaffold thrombosis (ScT) (overall ScT and early ScT) and ACS percentage with the latest publications, including the most recent large randomised controlled trials. Out of a total study population of 13,708 devices in 45 trials, overall ScT was observed in 185 devices (1.35%) at a weighted mean follow-up period of 9.4 months, while early ScT was reported in 125 devices (0.97%) out of 12,896 devices in 44 trials. Meta-regression analysis demonstrated no significant correlation between overall/early ScT and the percentage of patients with ACS (overall ScT: R2=0.030, p=0.255; early ScT: R2=0.067, p=0.090). CONCLUSIONS: ACS appeared to have little impact on the incidence of ScT after the implantation of BVS. Further clinical study is warranted to investigate the predictors of ScT using multivariate analysis with sufficient statistical power.
No takes yet. Share an insight, caveat, or question.
Sotomi et al. (2017) conducted a meta-analysis in Acute coronary syndrome (n=13,708). Acute coronary syndrome was evaluated on Incidence of definite/probable scaffold thrombosis (overall and early) (R2=0.030, p=0.255). The percentage of patients with acute coronary syndrome showed no significant correlation with overall (R2=0.030, p=0.255) or early (R2=0.067, p=0.090) scaffold thrombosis after BVS implantation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: