Meta-analysis of everolimus-eluting bioabsorbable vascular scaffolds versus everolimus-eluting metallic stents at three years

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Abstract

Background: This study aimed to assess the efficacy and safety of bioabsorbable vascular scaffolds (BVS) vs everolimus-eluting metallic stents (EES) after 3 years. Methods: MEDLINE, EMBASE, CENTRAL, and relevant websites were searched for articles published between 30 November 2006 and 18 December 2017. The primary efficacy outcome was target lesion revascularisation and the primary safety outcome was definite or probable stent (scaffold) thrombosis. Secondary outcomes included target lesion failure, myocardial infarction, death, all revascularisation, and patient-oriented composite endpoint. Odds ratios (ORs) and weighted mean differences with 95% CIs were derived, and the risk estimates for the outcomes according to a fixed-effects model were calculated. This study was registered with PROSPERO (CRD42017084290). Results: The study included five trials comprising data for 3,575 patients randomised to receive BVS (n = 2256) or EES (n = 1319). Patients treated with BVS had a non-statistically significant increased risk of target lesion revascularisation (OR 1.30, 95% CI 0.95–1.78, p = 0.10). Patients treated with a BVS had a higher risk of definite or probable stent thrombosis (OR 2.68, 95% CI 1.57–4.58, p < 0.001), target lesion failure (1.41, 1.12–1.78, p = 0.004), myocardial infarction (1.49, 1.13–1.98, p = 0.005), and a patient-oriented composite endpoint (1.21, 1.01–1.44, p = 0.038) than those treated with a metallic stent. Patients treated with BVS had no statistically significant differences in death (0.80, 0.51–1.25, p = 0.325) and all revascularisation (1.12, 0.91–1.40, p = 0.052) compared to those treated with EES. Conclusion: Bioabsorbable vascular scaffolds were inferior to EES at 3 years.
Original languageEnglish
Pages (from-to)S462-S462
Number of pages1
JournalHeart , Lung and Circulation
Volume27
Issue numberSuppl. 2
DOIs
Publication statusPublished - 2018

Keywords

  • stents (surgery)
  • cardiovascular system
  • coronary heart disease

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