BVS Examination long term outcome

Very long-term outcome of ABSORB bioresorbable vascular scaffold vs. everolimus-eluting metallic stent in ST-segment elevation myocardial infarction: 5-year results of the BVSEXAMINATION study

ABSTRACT

Aim: to compare 5-year clinical outcomes between everolimus-eluting bioresorbable scaffold (BRS) vs. everolimus-eluting metallic stent (EES) in STEMI patients.

Methods and results: This observational and retrospective study included 235 consecutive STEMI patients treated by BRS, compared with 235 STEMI patients treated with EES from the EXAMINATION trial, by applying propensity score matching. Primary endpoint was a device-oriented endpoint (DOCE), including cardiac death, target vessel myocardial infarction and target lesion revascularization at 5-year follow-up.Device thrombosis, according to the ARC criteria, was also evaluated.Optical coherence tomography (OCT) analysis was also performed at 5-year in event-free BRS patients. The cumulative incidence of 5-year DOCE was higher in BRS as compared to EES group (13.2% vs. 7.6%, HR [95%CI] 1.87 [0.94 – 3.44], p=0.071), mainly driven by higher rate of TLR (7.6% vs. 1.7%, HR [95%CI] 1.15 [0.44 – 2.30], p=0.004). Fiveyear definite BRS thrombosis rate was also higher as compared to EES (4.2% vs. 1.2%, HR [95%CI] 3.49 [0.95 – 12.82], p=0.054. Optical coherence tomography analysis showed high incidence of neo-atherosclerosis in BRS group.

Conclusions: Five-year event risk was higher with BRS vs EES in STEMI. This suggests that the probability of obtaining favorable results at very long-term follow-up is low. Whether better results will be obtained with new generation BVS remains to be determined.