Meta-Analysis Comparing Outcomes After Everolimus-Eluting Bioresorbable Vascular Scaffolds Versus Everolimus-Eluting Metallic Stents in Patients with Acute Coronary Syndromes
| Autor: | Roberta De Rosa, Maria Carmen De Angelis, Ilaria Radano, Gennaro Galasso, Federico Piscione, Marco Di Maio, Angelo Silverio, Rodolfo Citro, Elisabetta Moscarella, Attilio Varricchio, Giuseppe De Luca, Marta Belmonte |
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| Přispěvatelé: | De Rosa, R., Silverio, A., Varricchio, A., De Luca, G., Di Maio, M., Radano, I., Belmonte, M., De Angelis, M. C., Moscarella, E., Citro, R., Piscione, F., Galasso, G. |
| Rok vydání: | 2018 |
| Předmět: |
Target lesion
Acute coronary syndrome medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Prosthesis Design 03 medical and health sciences Immunosuppressive Agent 0302 clinical medicine Absorbable Implant Internal medicine Absorbable Implants medicine Drug-Eluting Stent Humans 030212 general & internal medicine Myocardial infarction Everolimus Acute Coronary Syndrome Tissue Scaffolds business.industry Stent Percutaneous coronary intervention Drug-Eluting Stents Odds ratio medicine.disease Thrombosis Everolimu Treatment Outcome Cardiology Cardiology and Cardiovascular Medicine business Immunosuppressive Agents medicine.drug Human |
| Zdroj: | The American journal of cardiology. 122(1) |
| ISSN: | 1879-1913 |
| Popis: | Acute coronary syndromes (ACS) may represent an intriguing clinical scenario for implantation of bioresorbable vascular scaffold (BRS). Nevertheless, the knowledge about the performance of these devices in patients with ACS is limited. Therefore, we performed a meta-analysis of clinical studies aiming to assess the safety and efficacy of everolimus-eluting-BRS versus everolimus-eluting-metallic stents (EES) in ACS patients undergoing percutaneous coronary intervention. Six studies enrolling 2,318 patients were included and analyzed for the risk of primary safety outcome (stent or scaffold thrombosis [ST/ScT]), primary efficacy outcome (target lesion revascularisation [TLR]), and secondary outcomes (myocardial infarction, cardiac death, all-cause death). Median follow-up was 9.5 (6 to 19.5) months. Patients treated with BRS had a significantly higher risk of definite ST/ScT compared with those receiving EES (2.3% vs 1.08%, odds ratio [OR] 2.22, 95% confidence interval [CI] 1.10 to 4.45, p = 0.03, I2 = 0%). Similarly, the risk of TLR was significantly higher in the BRS compared with EES group (3.5% vs 2.5%, OR 1.79, 95% CI 1.02 to 3.16, p = 0.04, I2 = 0%). When TLRs due to thrombosis were excluded, the difference in risk estimates between the 2 groups was no longer significant (OR 1.19, 95% CI 0.48 to 2.98, p = 0.71, I2 = 25%). Risk for secondary endpoints did not differ between the 2 groups. Results were confirmed when clinical and procedural variables were tested as potential effect modifiers in the meta-regression analysis for both primary endpoints. In conclusion, compared with those receiving EES, patients with ACS treated with BRS had increased risk of definite device thrombosis and TLR at mid-term follow-up. |
| Databáze: | OpenAIRE |
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