Thrombosis Odds Up With Bioresorbable Vascular Scaffolds
BVSs linked to increased risk of MI, target lesion revascularization and failure versus metallic stents
TUESDAY, Oct. 17, 2017 (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 online Oct. 16 in the Annals of Internal Medicine.
Xin-Lin Zhang, M.D., 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 seven 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 percent, respectively. In seven trials involving 5,578 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 one year versus within one 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.