title: Are BVS suitable for ACS patients? Support from a large single center real live registry.
abstract: OBJECTIVE
  To investigate one-year outcomes after implantation of a bioresorbable vascular scaffold (BVS) in patients presenting with acute coronary syndrome (ACS) compared to stable angina patients.
  
  
  BACKGROUND
  Robust data on the outcome of BVS in the setting of ACS is still scarce.
  
  
  METHODS
  Two investigator initiated, single-center, single-arm BVS registries have been pooled for the purpose of this study, namely the BVS Expand and BVS STEMI registries.
  
  
  RESULTS
  From September 2012-October 2014, 351 patients with a total of 428 lesions were enrolled. 255 (72.6%) were ACS patients and 99 (27.4%) presented with stable angina/silent ischemia. Mean number of scaffold/patient was 1.55±0.91 in ACS group versus 1.91±1.11 in non-ACS group (P=0.11). Pre- and post-dilatation were performed less frequent in ACS patients, 75.7% and 41.3% versus 89.0% and 62.0% respectively (P=0.05 and P=0.001). Interestingly, post-procedural acute lumen gain and percentage diameter stenosis were superior in ACS patients, 1.62±0.65mm (versus 1.22±0.49mm, P<0.001) and 15.51±8.47% (versus 18.46±9.54%, P=0.04). Major adverse cardiac events (MACE) rate at 12months was 5.5% in the ACS group (versus 5.3% in stable group, P=0.90). One-year definite scaffold thrombosis rate was comparable: 2.0% for ACS population versus 2.1% for stable population (P=0.94), however, early scaffold thromboses occurred only in ACS patients.
  
  
  CONCLUSIONS
  One-year clinical outcomes in ACS patients treated with BVS were similar to non-ACS patients. Acute angiographic outcomes were better in ACS than in non-ACS, yet the early thrombotic events require attention and further research.
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: Felix
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: Y
authors.initials: Y
authors.lastname: Onuma
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Fam
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Diletti
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: Y
authors.initials: Y
authors.lastname: Ishibashi
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: B R C
authors.initials: BRC
authors.lastname: Everaert
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: N M D A
authors.initials: NMDA
authors.lastname: van Mieghem
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Daemen
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: P P T
authors.initials: PPT
authors.lastname: de Jaegere
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands.
authors.forename: E S
authors.initials: ES
authors.lastname: Regar
authors.affiliation: Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands. Electronic address: r.vangeuns@erasmusmc.nl.
authors.forename: R J M
authors.initials: RJM
authors.lastname: van Geuns
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate / Q000639:trends; D054457:Tissue Scaffolds
keywords: Acute coronary syndrome; BVS; Bioresorbable vascular scaffold; Coronary artery disease; Percutaneous coronary intervention; Stable angina