title: Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter "real-world" registry.
abstract: BACKGROUND
  Safety and efficacy of bioresorbable vascular scaffolds (BRS) and the role of postdilatation on outcome in acute coronary syndrome (ACS) patients compared with those of everolimus-eluting stents (EES) remain unknown. The aim of the study is to compare the safety and efficacy of BRS with EES in ACS and to investigate the role of BRS postdilatation.
  
  
  METHODS
  Consecutive ACS patients undergoing BRS implantation in 8 centers were com-pared with those with EES before and after propensity score matching. Major adverse cardiac event (MACE), myocardial infarction, and target lesion revascularization (TLR) were the primary endpoint. Sensitivity analysis was performed according to postdilatation after BRS implantation. We enrolled 303 BRS and 748 EES patients; 215 from each group were com-pared after matching, and 117 (55.2%) BRS patients were treated with postdilatation.
  
  
  RESULTS
  After a median follow-up of 24.0 months, MACE rates were higher in BRS patients than in EES patients (9.3% vs. 4.7%, p < 0.001), mainly driven by TLR (6.1% vs. 1.9%, p < 0.001). Stent thrombosis increased in the BRS group (2.8% vs. 0.9%, p = 0.01). How-ever, after sensitivity analysis, MACE rates in BRS patients with postdilatation were signifi-cantly lower than in those without, comparable to EES patients (6.0% vs. 12.6% vs. 4.7%, p < 0.001). The same trend was observed for TLR (3.4% vs. 8.4% vs. 1.9%, p < 0.001). Stent thrombosis rates were higher in both the BRS groups than in EES patients (2.6% vs. 3.2% vs. 0.9%, p = 0.045).
  
  
  CONCLUSIONS
  Postdilatation appears effective when using BRS in ACS patients. MACE rates are comparable to those of EES, although scaffold thrombosis is not negligible. Randomized prospective studies are required for further investigation.
authors: Yoichi
authors: Y
authors: Imori
authors: Fabrizio
authors: F
authors: D'Ascenzo
authors: Tommaso
authors: T
authors: Gori
authors: Thomas
authors: T
authors: Münzel
authors: Ugo
authors: U
authors: Fabrizio
authors: Gianluca
authors: G
authors: Campo
authors: Enrico
authors: E
authors: Cerrato
authors: L Christian
authors: LC
authors: Napp
authors: Mario
authors: M
authors: Iannaccone
authors: Jelena R
authors: JR
authors: Ghadri
authors: Elycia
authors: E
authors: Kazemian
authors: Ronald K
authors: RK
authors: Binder
authors: Milosz
authors: M
authors: Jaguszewski
authors: Adam
authors: A
authors: Csordas
authors: Piera
authors: P
authors: Capasso
authors: Simone
authors: S
authors: Biscaglia
authors: Fedrico
authors: F
authors: Conrotto
authors: Ferdinando
authors: F
authors: Varbella
authors: Roberto
authors: R
authors: Garbo
authors: Fiorenzo
authors: F
authors: Gaita
authors: Paul
authors: P
authors: Erne
authors: Thomas F
authors: TF
authors: Lüscher
authors: Claudio
authors: C
authors: Moretti
authors: Antonio H
authors: AH
authors: Frangieh
authors: University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland. christian.templin@usz.ch.
authors: Christian
authors: C
authors: Templin
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004106:Dilatation / Q000379:methods; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D057216:Propensity Score; D012042:Registries; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: angina pectoris; cardiac death; coronary restenosis; myocardial infarction; thrombosis