Thrombosis Odds Up With Bioresorbable Vascular Scaffolds
BVSs were correlated with increased risks for myocardial infarction, target lesion revascularization, and target lesion failure.
HealthDay News — Everolimus-eluting bioresorbable vascular scaffolds (BVSs) are associated with increased odds of scaffold thrombosis and other thrombotic events compared with everolimus-eluting metallic stents (EESs), according to a review published in the Annals of Internal Medicine.
Xin-Lin Zhang, MD, from the Nanjing University School of Medicine in China, and colleagues compared the safety and efficacy of everolimus-eluting BVSs with that of EESs using data from 7 randomized trials and 38 observational studies involving adults with coronary artery disease who underwent percutaneous coronary intervention.
The researchers found that at a median follow-up of one year and beyond one year, the pooled incidence of definite or probable scaffold thrombosis after BVS implantation was 1.8% and 0.8%, respectively.
In 7 trials involving 5578 patients that directly compared BVSs with EESs, the risk of definite or probable scaffold thrombosis was increased with BVSs at a median follow-up of 25 months (odds ratio, 3.4). Increased risks were seen at early, late, and very late stages; the odds were almost double for beyond 1 year vs within 1 year. BVSs were correlated with increased risks for myocardial infarction, target lesion revascularization, and target lesion failure (odds ratios, 1.63, 1.31, and 1.37, respectively); over time, there were increases in the odds for these end points.
"Compared with EESs, BVSs increased the risks for scaffold thrombosis and other thrombotic events at mid- and long-term follow-up, and risks increased over time," the authors write.
Zhang XL, Zhu QQ, Kang LN, et al. Mid-and long-term outcome comparisons of everolimus-eluting bioresorbable scaffolds versus everolimus-eluting metallic stents: a systematic review and meta-analysis [published online October 17, 2017]. Ann Intern Med. doi: 10.7326/M17-1101