Comparison of everolimus- and biolimus-eluting coronary stents with everolimus-eluting bioresorbable vascular scaffolds

J Am Coll Cardiol. 2015 Mar 3;65(8):791-801. doi: 10.1016/j.jacc.2014.12.017.

Abstract

Background: The first CE-approved bioresorbable vascular scaffold (BVS) is effective at treating simple lesions and stable coronary artery disease, but it has yet to be assessed versus the best-in-class drug-eluting stents (DES).

Objectives: This study sought to compare the performance of a BVS with that of everolimus-eluting stents (EES) and biolimus-eluting stents (BES) in all-comer patients.

Methods: The EVERBIO II (Comparison of Everolimus- and Biolimus-Eluting Stents With Everolimus-Eluting Bioresorbable Vascular Scaffold Stents II) trial was a single-center, assessor-blinded study of 240 patients randomly assigned in a 1:1:1 ratio to EES, BES, or BVS. The only exclusion criterion was a reference vessel diameter >4.0 mm, which precluded treatment with BVS. The primary endpoint was angiographic late lumen loss (LLL) at 9 months. Secondary endpoints included patient-oriented major acute coronary events (MACE) (death, myocardial infarction [MI], and any revascularization), device-oriented MACE (cardiac death, MI, and target lesion revascularization), and stent thrombosis at the 9-month clinical follow-up.

Results: Follow-up angiography was performed in 216 patients (90.7%) at 9 months. In-stent LLL was similar between patients treated with BVS (0.28 ± 0.39 mm) and those treated with EES/BES (0.25 ± 0.36 mm; p = 0.30). Clinical outcomes were similar at 9 months: the patient-oriented MACE rate was 27% in BVS and 26% in the EES/BES group (p = 0.83) and the device-oriented MACE rate was 12% in BVS and 9% in the EES/BES group (p = 0.6).

Conclusions: New-generation metallic DES (EES/BES) were not superior to BVS in terms of angiographic LLL and clinical outcomes. (Comparison of Everolimus- and Biolimus-Eluting Stents With Everolimus-Eluting Bioresorbable Vascular Scaffold Stents [EVERBIO II]; NCT01711931).

Keywords: coronary artery disease; drug-eluting stent(s); late lumen loss; myocardial infarction; percutaneous coronary intervention.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants
  • Aged
  • Coronary Angiography / methods
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / surgery*
  • Coronary Restenosis* / diagnosis
  • Coronary Restenosis* / etiology
  • Coronary Restenosis* / prevention & control
  • Drug-Eluting Stents / adverse effects*
  • Everolimus
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Male
  • Materials Testing / methods
  • Middle Aged
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / prevention & control
  • Sirolimus / analogs & derivatives*
  • Sirolimus / pharmacology
  • Tissue Scaffolds
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Everolimus
  • umirolimus
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT01711931