Key result
Bioresorbable scaffold matches metallic stent for composite outcomes at two years.
Why the study?
The ABSORB II trial aimed to compare the two-year clinical outcomes of everolimus-eluting bioresorbable scaffold versus everolimus-eluting metallic stent in ischaemic heart disease caused by de novo native coronary artery lesions.
Does an everolimus-eluting bioresorbable scaffold improve clinical outcomes compared to an everolimus-eluting metallic stent in patients with ischaemic heart disease caused by de novo native coronary artery lesions?
RCT (n=501)
2:1 ratio
Does an everolimus-eluting bioresorbable scaffold improve clinical outcomes compared to an everolimus-eluting metallic stent in patients with ischaemic heart disease caused by de novo native coronary artery lesions?
At 2 years, the everolimus-eluting bioresorbable scaffold showed comparable rates of patient-oriented and device-oriented composite endpoints compared to a metallic everolimus-eluting stent, though with a numerically higher rate of device-oriented target lesion failure.
Answers are grounded in this paper and cite their sources.
Comparable 2-year PoCE/DoCE rates with BVS versus XIENCE; leaves open long-term advantages of bioresorption.
AIMS: The one-year randomised data of the ABSORB II trial showed that the everolimus-eluting bioresorbable scaffold and the everolimus-eluting metallic stent were comparable for the composite secondary clinical outcomes of patient-oriented composite endpoint (PoCE) and device-oriented composite endpoint (DoCE)/target lesion failure (TLF), MACE and TVF. This report describes the two-year clinical outcomes of the ABSORB II trial. METHODS AND RESULTS: Patients were randomly assigned in a 2:1 ratio to receive treatment with an everolimus-eluting bioresorbable scaffold (Absorb; Abbott Vascular, Santa Clara, CA, USA) or treatment with an everolimus-eluting metallic stent (XIENCE; Abbott Vascular). The trial enrolled 501 patients. Clinical follow-up at two years was available in 320 patients in the Absorb BVS arm and 160 patients in the XIENCE arm. At two years, the PoCE for the Absorb and XIENCE arms was 11.6% and 12.8% (p=0.70) and the DoCE/TLF was 7.0% and 3.0% (p=0.07), respectively. The hierarchical ID-MACE rate was 7.6% vs. 4.3% (p=0.16) and the rate of TVF was 8.5% vs. 6.7% (p=0.48). The definite/probable thrombosis rate was 1.5% in the Absorb arm vs. 0% in the XIENCE arm (p=0.17). Thirty-six percent and 34% of patients remained on DAPT at two years, respectively. Ninety-two percent of patients in both arms remained on aspirin. CONCLUSIONS: Two-year clinical results demonstrate sustained low rates of PoCE, MACE, DoCE and TVF with the Absorb BVS as compared to the XIENCE stent.
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Chevalier et al. (2016) conducted an RCT in ischaemic heart disease caused by de novo native coronary artery lesions (n=501). everolimus-eluting bioresorbable scaffold (Absorb) vs. everolimus-eluting metallic stent (XIENCE) was evaluated on patient-oriented composite endpoint (PoCE) (p=0.70). The everolimus-eluting bioresorbable scaffold resulted in similar rates of the patient-oriented composite endpoint compared to a metallic stent at two years (11.6% vs 12.8%, p=0.70).
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