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3-Year Clinical Outcomes With Everolimus-Eluting Bioresorbable Coronary Scaffolds
- Source :
- Journal of the American College of Cardiology. 70:2852-2862
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background The Absorb everolimus-eluting poly-L-lactic acid–based bioresorbable vascular scaffold (BVS) provides early drug delivery and mechanical support functions similar to metallic drug-eluting stents (DES), followed by complete bioresorption in approximately 3 years with recovery of vascular structure and function. The ABSORB III trial demonstrated noninferior rates of target lesion failure (cardiac death, target vessel myocardial infarction [TVMI], or ischemia-driven target lesion revascularization) at 1 year in 2,008 patients with coronary artery disease randomized to BVS versus cobalt-chromium everolimus-eluting stents (EES). Objectives This study sought to assess clinical outcomes through 3 years following BVS implantation. Methods Clinical outcomes from the ABSORB III trial were analyzed by randomized treatment assignment cumulative through 3 years, and between 1 and 3 years. Results The primary composite endpoint of target lesion failure through 3 years occurred in 13.4% of BVS patients and 10.4% of EES patients (p = 0.06), and between 1 and 3 years in 7.0% versus 6.0% of patients, respectively (p = 0.39). TVMI through 3 years was increased with BVS (8.6% vs. 5.9%; p = 0.03), as was device thrombosis (2.3% vs. 0.7%; p = 0.01). In BVS-assigned patients, treatment of very small vessels (those with quantitatively determined reference vessel diameter Conclusions In the ABSORB III trial, 3-year adverse event rates were higher with BVS than EES, particularly TVMI and device thrombosis. Longer-term clinical follow-up is required to determine whether bioresorption of the polymeric scaffold will influence patient prognosis. (ABSORB III Randomized Controlled Trial [RCT] [ABSORB-III]; NCT01751906)
- Subjects :
- Target lesion
medicine.medical_specialty
Everolimus
business.industry
medicine.medical_treatment
Stent
030204 cardiovascular system & hematology
medicine.disease
Thrombosis
law.invention
Surgery
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Medicine
030212 general & internal medicine
Myocardial infarction
Cardiology and Cardiovascular Medicine
business
Adverse effect
medicine.drug
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi...........51a0c040be3177384d63752e16b3cc70
- Full Text :
- https://doi.org/10.1016/j.jacc.2017.10.010