Friedrich-Alexander Universität Erlangen-Nürnberg, Department of Cardiology, Erlangen, Germany.
Medizinische Klinik I, Department of Cardiology, University of Giessen, Giessen, Germany.
Catheter Cardiovasc Interv. 2021 Oct;98(4):E564-E570. doi: 10.1002/ccd.29831. Epub 2021 Jun 17.
To identify potential differences in 2-year outcome between patients who underwent coronary revascularization using bioresorbable vascular scafffolds (BVS) in stable coronary artery disease (CAD) and acute coronary syndromes (ACS).
Data from randomized trials suggest a significantly higher event rate following coronary revascularization using everolimus-eluting BVS as compared to new generation drug eluting stents. Whether particular patient subgroups are at increased risk for scaffold thrombosis and target lesion failure (TLF) has not clearly been demonstrated.
German-Austrian ABSORB RegIstRy is a prospective all-comer multi-center observational study of consecutive patients who were considered for coronary revascularization with BVS. We compared 1499 patients with stable CAD to 1594 patients with ACS. Endpoints were major adverse cardiac events (MACE), TLF, and scaffold thrombosis.
While single vessel disease was more prevalent in ACS (46% vs. 37%, p < 0.0001), lesion complexity (B2/C stenosis 37% vs. 36%, bifurcation 2.4% vs. 3.4%, p < 0.05), number of implanted scaffolds/patient (1.34 vs. 1.43), scaffold length (18 vs. 18 mm) or the rate of high pressure postdilatation (68% vs. 70%) did not differ between ACS and stable CAD. Two-year MACE rates were 11.6% in ACS and 11.4% in stable CAD, TLF occurred in 7.0% versus 7.4% and target vessel revascularization in 8.8 versus 10.2% (n.s. for all). Definite scaffold thrombosis rates were not significantly different (ACS 1.9% vs. stable CAD 2.1%).
Real-world 2-year event rates after coronary revascularization with BVS are not significantly different between individuals with ACS as compared to stable CAD.
确定在稳定型冠心病（CAD）和急性冠状动脉综合征（ACS）患者中，使用生物可吸收血管支架（BVS）进行冠状动脉血运重建的患者，其 2 年结果是否存在潜在差异。
随机试验的数据表明，与新一代药物洗脱支架相比，使用依维莫司洗脱 BVS 进行冠状动脉血运重建后，事件发生率明显更高。特定患者亚组是否存在支架血栓形成和靶病变失败（TLF）的风险增加尚未明确。
德国-奥地利 ABSORB 注册研究是一项前瞻性、多中心、连续患者观察性研究，这些患者被认为需要使用 BVS 进行冠状动脉血运重建。我们比较了 1499 例稳定型 CAD 患者和 1594 例 ACS 患者。主要心脏不良事件（MACE）、TLF 和支架血栓形成是终点事件。
ACS 患者中单支血管病变更为常见（46%比 37%，p<0.0001），病变复杂性（B2/C 狭窄 37%比 36%，分叉 2.4%比 3.4%，p<0.05）、植入支架数/患者（1.34 比 1.43）、支架长度（18 比 18mm）或高压后扩张率（68%比 70%）在 ACS 和稳定型 CAD 之间无差异。ACS 的 2 年 MACE 发生率为 11.6%，稳定型 CAD 为 11.4%，TLF 发生率分别为 7.0%和 7.4%，靶血管血运重建发生率分别为 8.8%和 10.2%（均无统计学差异）。确定的支架血栓形成发生率无显著差异（ACS 为 1.9%，稳定型 CAD 为 2.1%）。
在使用 BVS 进行冠状动脉血运重建后，ACS 患者与稳定型 CAD 患者相比，2 年的实际事件发生率没有显著差异。
