Clinical outcomes of bioresorbable vascular scaffold to treat all-comer patients. Are patients with acute coronary syndrome better candidates for bioresorbable vascular scaffold?

Autor: Victor-Xavier Tadros, Mohamed Nosair, Serge Doucet, Raoul Bonan, Fabien Picard, Robert Avram, Gilbert Gosselin, Anita W. Asgar, Philippe L-L'allier, Jean-François Dorval, Hung Q. Ly, Guillaume Marquis-Gravel, Quentin de Hemptinne, Reda Ibrahim, Jean-François Tanguay
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Acute coronary syndrome
Time Factors
medicine.medical_treatment
Population
Clinical Decision-Making
Coronary Artery Disease
030204 cardiovascular system & hematology
Revascularization
Prosthesis Design
Risk Assessment
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Risk Factors
Internal medicine
Absorbable Implants
medicine
Clinical endpoint
Humans
030212 general & internal medicine
Myocardial infarction
Acute Coronary Syndrome
education
Adverse effect
Aged
Retrospective Studies
education.field_of_study
business.industry
Patient Selection
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Treatment Outcome
Coronary Occlusion
Chronic Disease
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Cardiovascular revascularization medicine : including molecular interventions. 20(3)
ISSN: 1878-0938
Popis: Background Scaffold thromboses (ST) and adverse events and have been associated with bioresorbable vascular scaffolds (BVS) at long-term, but their mechanism remains unclear. We sought to evaluate patient and lesion characteristics associated with mid- to long-term outcomes in patients treated with BVS. Methods This is an observational single-center, single-arm, retrospective study evaluating the performance of BVS in an all-comer population, including complex lesions (chronic total occlusions, long lesions), small vessels, and acute coronary syndromes (ACS). Results From May 2013 to June 2015, we included 482 patients (580 lesions) that were treated with BVS implantation including 71.2% treated for ACS in the present analysis. Mean follow-up period was 816.2 ± 242.6 days. The primary endpoint was device oriented cardiac events (DOCE), defined as a composite of target-lesion revascularization (TLR), ST, target vessel myocardial infarction (TVMI) and cardiac death. Using Kaplan-Meier methods , the DOCE and ST rates at 36 months were 9.4% and 2.3%, respectively. No ST occurred between 2 and 3 years and ST occurred after 3 years, in one patient. Using multivariate analysis , ACS was the only significant predictor of lower rates of DOCE ( p = 0.04, HR: 0.47, 95% CI: 0.23–0.96). Conclusions In this large all-comers real-world cohort, lesions treated with BVS had non-negligible rates of DOCE and ST, in line with previous published randomized trials. The occurrence of very late event was very low after 24 months. ACS patients had lower rates of DOCE.
Databáze: OpenAIRE
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