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Outcome of percutaneous coronary intervention with the Absorb bioresorbable scaffold : Data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

Grimfjärd, Per ; James, Stefan ; Persson, Jonas ; Angerås, Oskar ; Koul, Sasha LU ; Omerovic, Elmir ; Varenhorst, Christoph ; Lagerqvist, Bo and Erlinge, David LU orcid (2017) In EuroIntervention 13(11). p.1304-1311
Abstract

Aims: Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug-eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS. Methods and results: The Absorb BRS (n=810) was compared with commonly used modern DES (n=67,909). The main outcome measure was definite ST; mean follow-up was two years. Despite being implanted in a younger, lower-risk population compared with modern DES, the Absorb BRS was associated with a higher crude incidence of definite ST at stent level: 1.5 vs. 0.6%, hazard ratio (HR) 2.38 (95% confidence interval... (More)

Aims: Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug-eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS. Methods and results: The Absorb BRS (n=810) was compared with commonly used modern DES (n=67,909). The main outcome measure was definite ST; mean follow-up was two years. Despite being implanted in a younger, lower-risk population compared with modern DES, the Absorb BRS was associated with a higher crude incidence of definite ST at stent level: 1.5 vs. 0.6%, hazard ratio (HR) 2.38 (95% confidence interval [CI]: 1.34-4.23), adjusted HR 4.34 (95% CI: 2.37-7.94); p<0.001. The patient level adjusted HR was 4.44 (95% CI: 2.25-8.77). Rates of in-stent restenosis were similar for BRS and DES. Non-compliance with dual antiplatelet therapy (DAPT) guidelines was noted in six out of 12 BRS ST events. Three very late ST events occurred with the Absorb BRS. Conclusions: In this real-world observational study, the Absorb BRS was associated with a significantly higher risk of definite ST compared with modern DES. Non-compliance with DAPT guideline recommendations was common among Absorb definite ST events.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bioresorbable scaffolds, Drug-eluting stent, In-stent restenosis, Stent thrombosis
in
EuroIntervention
volume
13
issue
11
pages
8 pages
publisher
Société Europa Edition
external identifiers
  • pmid:28781242
  • scopus:85039778439
ISSN
1774-024X
DOI
10.4244/EIJ-D-17-00458
language
English
LU publication?
yes
id
41832b98-299a-4a7c-8787-d232e4535298
date added to LUP
2018-01-22 17:06:08
date last changed
2024-03-01 12:45:31
@article{41832b98-299a-4a7c-8787-d232e4535298,
  abstract     = {{<p>Aims: Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug-eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS. Methods and results: The Absorb BRS (n=810) was compared with commonly used modern DES (n=67,909). The main outcome measure was definite ST; mean follow-up was two years. Despite being implanted in a younger, lower-risk population compared with modern DES, the Absorb BRS was associated with a higher crude incidence of definite ST at stent level: 1.5 vs. 0.6%, hazard ratio (HR) 2.38 (95% confidence interval [CI]: 1.34-4.23), adjusted HR 4.34 (95% CI: 2.37-7.94); p&lt;0.001. The patient level adjusted HR was 4.44 (95% CI: 2.25-8.77). Rates of in-stent restenosis were similar for BRS and DES. Non-compliance with dual antiplatelet therapy (DAPT) guidelines was noted in six out of 12 BRS ST events. Three very late ST events occurred with the Absorb BRS. Conclusions: In this real-world observational study, the Absorb BRS was associated with a significantly higher risk of definite ST compared with modern DES. Non-compliance with DAPT guideline recommendations was common among Absorb definite ST events.</p>}},
  author       = {{Grimfjärd, Per and James, Stefan and Persson, Jonas and Angerås, Oskar and Koul, Sasha and Omerovic, Elmir and Varenhorst, Christoph and Lagerqvist, Bo and Erlinge, David}},
  issn         = {{1774-024X}},
  keywords     = {{Bioresorbable scaffolds; Drug-eluting stent; In-stent restenosis; Stent thrombosis}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1304--1311}},
  publisher    = {{Société Europa Edition}},
  series       = {{EuroIntervention}},
  title        = {{Outcome of percutaneous coronary intervention with the Absorb bioresorbable scaffold : Data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)}},
  url          = {{http://dx.doi.org/10.4244/EIJ-D-17-00458}},
  doi          = {{10.4244/EIJ-D-17-00458}},
  volume       = {{13}},
  year         = {{2017}},
}