Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Cardiol J. 2022;29(4):563-573. doi: 10.5603/CJ.a2021.0040. Epub 2021 Apr 12.
Bioresorbable scaffolds (BRS) were considered to be beneficial for coronary bifurcation lesions regarding the avoidance of lateral branch opening incarceration after complete absorption. However, data is limited in this setting. The aim of this meta-analysis was to evaluate the short (6-month) and medium-term (1-year) outcomes of BRS in patients with coronary bifurcation lesions.
PubMed, EMBASE, Web of Science, Cochrane library databases were searched to find the studies of BRS implantation in patients with coronary bifurcation lesions. The effective outcome was target lesion revascularization. The safety outcomes included major adverse cardiovascular events, target vessel revascularization, myocardial infarction, definite or probable scaffold thrombosis, and cardiac death.
A total of 1204 patients involved in 12 studies were included. The pooled estimate rate of target lesion revascularization as efficacy outcome was highly consistent between 6-month and 1-year follow-up, which was 4.74% (95% CI 2.36-9.54%, I² = 41.5%, p = 0.14) and 4.37% (95% CI 3.05-5.69%, I² = 4.6%, P = 0.39). The pooled estimated rate of major adverse cardiovascular events as safety outcome was 5.50% and 7.31% for both 6-month and 1-year follow-up. The pooled estimated rate of target vessel revascularization, myocardial infarction, definite or probable scaffold thrombosis, and cardiac death at 1-year follow-up was 5.92%, 2.52%, 1.69%, and 0.42%.
The application of BRS for coronary bifurcation lesions is acceptable in efficacy outcome, but the high rate of scaffold thrombosis remains of concern (Registered by PROSPERO, CRD42019140341).
生物可吸收支架（BRS）被认为在避免完全吸收后侧支开口嵌顿时对冠状动脉分叉病变有益。然而，在这种情况下的数据有限。本荟萃分析的目的是评估冠状动脉分叉病变患者使用 BRS 的短期（6 个月）和中期（1 年）结果。
检索 PubMed、EMBASE、Web of Science、Cochrane 图书馆数据库，以找到冠状动脉分叉病变患者植入 BRS 的研究。有效结果是靶病变血运重建。安全性结果包括主要不良心血管事件、靶血管血运重建、心肌梗死、明确或可能的支架血栓形成和心脏死亡。
共有 1204 例患者纳入 12 项研究。6 个月和 1 年随访时，靶病变血运重建的汇总估计发生率在疗效结果方面非常一致，分别为 4.74%（95%CI 2.36-9.54%，I²=41.5%，p=0.14）和 4.37%（95%CI 3.05-5.69%，I²=4.6%，P=0.39）。安全性结果中主要不良心血管事件的汇总估计发生率为 6 个月和 1 年随访时分别为 5.50%和 7.31%。1 年随访时靶血管血运重建、心肌梗死、明确或可能的支架血栓形成和心脏死亡的汇总估计发生率分别为 5.92%、2.52%、1.69%和 0.42%。
BRS 应用于冠状动脉分叉病变在疗效结果方面是可以接受的，但支架血栓形成的高发生率仍令人担忧（由 PROSPERO 注册，CRD42019140341）。
