Scaffold Thrombosis After Percutaneous Coronary Intervention With ABSORB Bioresorbable Vascular Scaffold
| Autor: | Hadiya A. Benn, Rebecca Torguson, Michael A. Gaglia, Ricardo O. Escarcega, Nevin C. Baker, Michael J. Lipinski, Ron Waksman |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Acute coronary syndrome
medicine.medical_specialty business.industry medicine.medical_treatment Percutaneous coronary intervention Odds ratio 030204 cardiovascular system & hematology medicine.disease Thrombosis Surgery 03 medical and health sciences 0302 clinical medicine Meta-analysis Internal medicine Conventional PCI medicine Cardiology 030212 general & internal medicine Myocardial infarction Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | JACC: Cardiovascular Interventions. 9:12-24 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2015.09.024 |
| Popis: | Objectives The aim of this study was to determine the risk of scaffold thrombosis (ST) after percutaneous coronary intervention (PCI) with placement of an ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) by conducting a systematic review and meta-analysis. Background PCI with BVS placement holds great potential, but concern has recently been raised regarding the risk of ST. Methods MEDLINE/PubMed, Cochrane CENTRAL, and meeting abstracts were searched for all studies that included outcomes data for patients after PCI with BVS placement. For studies comparing BVSs with drug-eluting stents (DES), pooled estimates of outcomes, presented as odds ratios (ORs) with 95% confidence intervals (CIs), were generated with random-effects models. Results Our analysis included 10,510 patients (8,351 with a BVS and 2,159 with DES) with a follow-up of 6.4 ± 5.1 months and 60 ± 11 years of age; 78% were male, 36% had stable angina, and 59% had acute coronary syndrome (ACS). Among patients with a BVS, cardiovascular death occurred in 0.6%, myocardial infarction (MI) in 2.1%, target lesion revascularization in 2.0%, and definite/probable ST in 1.2% of patients. Of BVS patients, 0.27% had acute ST and 0.57% had subacute ST. Meta-analysis demonstrated that patients who received a BVS were at a higher risk of MI (OR: 2.06, 95% CI: 1.31 to 3.22, p = 0.002) and definite/probable ST (OR: 2.06, 95% CI: 1.07 to 3.98, p = 0.03) compared with patients who received DES, whereas there was a trend toward decreased all-cause mortality with a BVS (OR: 0.40, 95% CI: 0.15 to 1.06, p = 0.06). Conclusions Patients undergoing PCI with a BVS had increased definite/probable ST and MI during follow-up compared with DES. Further studies with long-term follow-up are needed to assess the risk of ST with a BVS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|