title: Comparative Efficacy and Safety of Everolimus-Eluting Bioresorbable Scaffold Versus Everolimus-Eluting Metallic Stents: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Theoretically, the everolimus-eluting bioresorbable vascular scaffold (BVS) could eliminate stent thrombosis and improve outcomes in patients having percutaneous coronary intervention.
  
  
  OBJECTIVE
  To estimate the incidence of stent thrombosis after BVS implantation and to compare the efficacy and safety of BVSs versus everolimus-eluting metallic stents (EESs) in adults having percutaneous coronary intervention.
  
  
  METHODS
  PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 20 January 2016.
  
  
  METHODS
  6 randomized, controlled trials and 38 observational studies, each involving at least 40 patients with BVS implantation.
  
  
  METHODS
  Two reviewers independently extracted study data and evaluated study risk of bias.
  
  
  RESULTS
  The pooled incidence of definite or probable stent thrombosis after BVS implantation was 1.5 events per 100 patient-years (PYs) (95% CI, 1.2 to 2.0 events per 100 PYs) (126 events during 8508 PYs). Six randomized trials that directly compared BVSs with EESs showed a non-statistically significant increased risk for stent thrombosis (odds ratio [OR], 2.05 [CI, 0.95 to 4.43]; P = 0.067) and myocardial infarction (OR, 1.38 [CI, 0.98 to 1.95]; P = 0.064) with BVSs. The 6 observational studies that compared BVSs with EESs showed increased risk for stent thrombosis (OR, 2.32 [CI, 1.06 to 5.07]; P = 0.035) and myocardial infarction (OR, 2.09 [CI, 1.23 to 3.55]; P = 0.007) with BVSs. The relative rates of all-cause and cardiac death, revascularization, and target lesion failure were similar for BVSs and EESs.
  
  
  CONCLUSIONS
  Scarce comparative data, no published data from large trials with long-term follow-up, and limited quality and incomplete reporting of observational studies.
  
  
  CONCLUSIONS
  Compared with EESs, BVSs do not eliminate and might increase risks for stent thrombosis and myocardial infarction in adults having percutaneous coronary intervention. Results of large trials with long-term follow-up are critically needed to establish the safety or at least the noninferiority of BVSs compared with EESs.
  
  
  BACKGROUND
  None.
authors.forename: Xin-Lin
authors.initials: XL
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Zhong-Hai
authors.initials: ZH
authors.lastname: Wei
authors.forename: Qing-Qing
authors.initials: QQ
authors.lastname: Zhu
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Qiao
authors.forename: Qing
authors.initials: Q
authors.lastname: Dai
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Xie
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Kang
authors.forename: Lian
authors.initials: L
authors.lastname: Wang
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
mesh_terms: D020341:Absorbable Implants; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002423:Cause of Death; D057186:Comparative Effectiveness Research; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects; D000068338:Everolimus / Q000008:administration & dosage*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011183:Postoperative Complications; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D054457:Tissue Scaffolds
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus