title: Absorb bioresorbable vascular scaffold versus everolimus-eluting metallic stent in ST-segment elevation myocardial infarction: 1-year results of a propensity score matching comparison: the BVS-EXAMINATION Study (bioresorbable vascular scaffold-a clinical evaluation of everolimus eluting coronary stents in the treatment of patients with ST-segment elevation myocardial infarction).
abstract: OBJECTIVE
  The purpose of this study was to compare the 1-year outcome between bioresorbable vascular scaffold (BVS) and everolimus-eluting metallic stent (EES) in ST-segment elevation myocardial infarction (STEMI) patients.
  
  
  BACKGROUND
  The Absorb BVS (Abbott Vascular, Santa Clara, California) is a polymeric scaffold approved for treatment of stable coronary lesions. Limited and not randomized data are available on its use in ST-segment elevation myocardial infarction (STEMI) patients.
  
  
  METHODS
  This study included 290 consecutive STEMI patients treated by BVS, compared with either 290 STEMI patients treated with EES or 290 STEMI patients treated with bare-metal stents (BMS) from the EXAMINATION (A Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment of Patients With ST-segment Elevation Myocardial Infarction) trial, by applying propensity score matching. The primary endpoint was a device-oriented endpoint (DOCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization, at 1-year follow-up. Device thrombosis, according to the Academic Research Consortium criteria, was also evaluated.
  
  
  RESULTS
  The cumulative incidence of DOCE did not differ between the BVS and EES or BMS groups either at 30 days (3.1% vs. 2.4%, hazard ratio [HR]: 1.31 [95% confidence interval (CI): 0.48 to 3.52], p = 0.593; vs. 2.8%, HR: 1.15 [95% CI: 0.44 to 2.30], p = 0.776, respectively) or at 1 year (4.1% vs. 4.1%, HR: 0.99 [95% CI: 0.23 to 4.32], p = 0.994; vs. 5.9%, HR: 0.50 [95% CI: 0.13 to 1.88], p = 0.306, respectively). Definite/probable BVS thrombosis rate was numerically higher either at 30 days (2.1% vs. 0.3%, p = 0.059; vs. 1.0%, p = 0.324, respectively) or at 1 year (2.4% vs. 1.4%, p = 0.948; vs. 1.7%, p = 0.825, respectively), as compared with EES or BMS.
  
  
  CONCLUSIONS
  At 1-year follow-up, STEMI patients treated with BVS showed similar rates of DOCE compared with STEMI patients treated with EES or BMS, although rate of scaffolds thrombosis, mostly clustered in the early phase, was not negligible. Larger studies with longer follow-up are needed to confirm our findings.
authors.affiliation: Thorax Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. Electronic address: sabrugal@clinic.ub.es.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Medizinische Klinik und Poliklinik für Kardiologie, Angiologie und innere Intensivmedizin, Mainz, Germany.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: Cardiac Department, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Low
authors.affiliation: Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Tousek
authors.affiliation: Cardiology Department, Interventional Cardiology Unit, Virgen de la Arrixaca Hospital, Murcia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Pinar
authors.affiliation: Institute of Cardiology, Hospital of Bellvitge, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.affiliation: Thorax Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Giancarla
authors.initials: G
authors.lastname: Scalone
authors.affiliation: Medizinische Klinik und Poliklinik für Kardiologie, Angiologie und innere Intensivmedizin, Mainz, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Schulz
authors.affiliation: Cardiac Department, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
authors.affiliation: Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Viktor
authors.initials: V
authors.lastname: Kocka
authors.affiliation: Cardiology Department, Interventional Cardiology Unit, Virgen de la Arrixaca Hospital, Murcia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Hurtado
authors.affiliation: Institute of Cardiology, Hospital of Bellvitge, Barcelona, Spain.
authors.forename: Juan Antoni
authors.initials: JA
authors.lastname: Gomez-Hospital
authors.affiliation: Medizinische Klinik und Poliklinik für Kardiologie, Angiologie und innere Intensivmedizin, Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.affiliation: Cardiac Department, National University Heart Centre Singapore, National University Health System, Singapore.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Institute of Cardiology, Hospital of Bellvitge, Barcelona, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier
authors.affiliation: Cardiology Department, Interventional Cardiology Unit, Virgen de la Arrixaca Hospital, Murcia, Spain.
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
authors.affiliation: Cardiocenter, Third Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.affiliation: Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.affiliation: Thorax Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003328:Coronary Thrombosis / Q000209:etiology; D016208:Databases, Factual; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D000068338:Everolimus; D020123:Sirolimus
keywords: ABSORB; STEMI; everolimus-eluting stent