Serenelli Matteo, Biscaglia Simone, Tonet Elisabetta, Poli Arnaldo, Nicolini Elisa, Ielasi Alfonso, Erriquez Andrea, Campo Gianluca
Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Ferrara, Italy.
Unità di Cardiologia, ASST Milanese Ovest, Ospedale di Legnano, Milano, Italy.
J Thorac Dis. 2017 Aug;9(Suppl 9):S898-S902. doi: 10.21037/jtd.2017.06.111.
To evaluate how the 3-year results from the "A clinical evaluation to compare the safety, efficacy and performance of ABSORB everolimus eluting bioresorbable vascular scaffold (BVS) system against XIENCE everolimus eluting coronary stent system in the treatment of subjects with ischemic heart disease caused by de novo native coronary artery lesions" (ABSORB II) trial have influenced clinical practice among Italian interventional cardiologists.
We performed a survey among 95 interventional cardiologists sending a brief questionnaire by electronic mail. We collected 65 replies and analysed the data.
The opinion of the operators regarding the two main endpoints of the study ABSORB II was conflicting. However, 66% of the operators considered at least one of the two co-primary endpoints (late lumen loss or vasomotion) unreliable and not reflecting clinical practice. Asking about an explanation for the negative results of the study, we found that the 91% of the operators considered the implantation technique the main limit of the ABSORB II. Furthermore, 74% of the operators affirmed that the results from the study did not decrease the number of scaffold implanted in their cath-lab.
Absorb II trial did not influence clinical practice among Italian interventional cardiologists mainly due to the overall idea that the co-primary endpoints were not adequate to provide a robust evidence on device clinical safety and also because the lack of experience on device implantation may have influenced the outcomes.
评估“一项临床评估,旨在比较依维莫司洗脱生物可吸收血管支架(BVS)系统(ABSORB)与依维莫司洗脱冠状动脉支架系统(XIENCE)在治疗由初发原生冠状动脉病变引起的缺血性心脏病患者中的安全性、有效性和性能”(ABSORB II)试验的3年结果如何影响意大利介入心脏病学家的临床实践。
我们通过电子邮件向95位介入心脏病学家发送了一份简短问卷进行调查。我们收集了65份回复并分析了数据。
操作人员对ABSORB II研究的两个主要终点的看法存在冲突。然而,66%的操作人员认为两个共同主要终点(晚期管腔丢失或血管运动)中的至少一个不可靠,不能反映临床实践。在询问对该研究阴性结果的解释时,我们发现91%的操作人员认为植入技术是ABSORB II的主要限制因素。此外,74%的操作人员肯定该研究结果并未减少他们导管室中植入支架的数量。
ABSORB II试验并未影响意大利介入心脏病学家的临床实践,主要原因是总体认为共同主要终点不足以提供关于器械临床安全性的有力证据,并且由于器械植入经验的缺乏可能影响了结果。