Initial experience with bioresorbable vascular scaffolds for percutaneous revascularisation in patients with acute coronary syndrome

Abstract

Aim: Bioresorbable vascular scaffolds (BVS) have recently been introduced to minimise the long-term complications of metallic stents in acute coronary syndrome (ACS), but their benefits have not been well analysed.

Methods: The authors studied all ACS patients treated with any kind of stent at a single centre between March 2013 (when the first BVS was implanted) and June 2016.

Results: The study included 951 subjects, mean age 67.9 ± 13.3 years, mean Global Registry of Acute Coronary Events (GRACE) score 148.5 ± 44.8, 75.2% men and 38.2% with an ST-segment elevation myocardial infarction. The mean number of stents implanted was 1.3 ± 1.0 and 54 subjects (5.7%) received at least 1 BVS. Drug-eluting stents were implanted in 57.3% subjects, followed by bare-metal stents (19.0%). The subjects treated with BVS were younger and had lower GRACE scores compared to the rest. In-hospital mortality was 4.8% and no subject treated with BVS died before discharge. BVS-treated patients received dual antiplatelet therapy or new antiplatelet agents more frequently. During a median follow-up of 13 months, all-cause mortality was 7.8%, cardiovascular mortality was 6.1%, and at least 1 major cardiovascular event occurred in 26.4% of the subjects. Stent type did not affect prognosis.

Conclusion: Coronary revascularisation using BVS in selected ACS patients is safe and effective.

Keywords

Bioresorbable vascular stents / stents / acute coronary syndrome / revascularisation / prognosis

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