One-year efficacy and safety of everolimus-eluting bioresorbable scaffolds in the setting of acute myocardial infarction

PLoS One. 2020 Jul 9;15(7):e0235673. doi: 10.1371/journal.pone.0235673. eCollection 2020.

Abstract

Background and objectives: This study sought to compare clinical outcomes between bioresorbable scaffolds (BRS) and durable polymer everolimus-eluting metallic stents (DP-EES) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI).

Methods: From March 2016 to October 2017, 952 patients with AMI without cardiogenic shock undergoing successful PCI with BRS (n = 136) or DP-EES (n = 816) were enrolled from a multicenter, observational Korea Acute Myocardial Infarction Registry.

Results: In the crude population, there was no significant difference in the 1-year rate of device-oriented composite endpoint (DOCE) and device thrombosis between the BRS and DP-EES groups (2.2% vs. 4.8%, hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.13-1.41, p = 0.163; 0.7% vs. 0.5%, HR 1.49, 95% CI 0.16-13.4, p = 0.719, respectively). BRS implantation was opted in younger patients (53.7 vs. 62.6 years, p < 0.001) with low-risk profiles, and intravascular image-guided PCI was more preferred in the BRS group (60.3% vs. 27.2%, p < 0.001).

Conclusions: At 1-year follow-up, no differences in the rate of DOCE and device thrombosis were observed between patients with AMI treated with BRS and those treated with DP-EES. Our data suggest that imaging-guided BRS implantation in young patients with low risk profiles could be a reasonable strategy in the setting of AMI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants / adverse effects*
  • Acute Disease / therapy
  • Adult
  • Aged
  • Cardiovascular Agents / therapeutic use
  • Drug-Eluting Stents / adverse effects*
  • Endpoint Determination
  • Everolimus / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / surgery*
  • Myocardial Infarction / therapy
  • Percutaneous Coronary Intervention / adverse effects*
  • Proportional Hazards Models
  • Republic of Korea
  • Thrombosis / etiology
  • Tissue Scaffolds / adverse effects
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Everolimus

Grants and funding

It was supported by a grant from Chonnam National University Hospital Biomedical Research Institute (BCRI18015) and from the Korean Health Technology R & D Project (HI13C1527), sponsored by the Ministry of Health and Welfare, Republic of Korea.