title: Impact of overlapping on 1-year clinical outcomes in patients undergoing everolimus-eluting bioresorbable scaffolds implantation in routine clinical practice: Insights from the European multicenter GHOST-EU registry.
abstract: BACKGROUND
  Overlapping implantation of bioresorbable scaffolds (BRSs) are frequent in long coronary lesions. Its impact on clinical outcomes is unknown.
  
  
  OBJECTIVE
  To compare the clinical outcomes of patients treated with overlapping BRS with those patients treated with no-overlap BRS.
  
  
  METHODS
  We analyzed the 1-year clinical outcomes of 1,477 patients treated with BRS in the GHOST-EU registry, according to the implantation of overlapping BRS. Primary endpoint was patient oriented composite endpoint (PoCE) of: all-cause death, any myocardial infarction (MI) and any repeated revascularization. Scaffold thrombosis, according to Academic Research Consortium definition, was also analyzed.
  
  
  RESULTS
  A total of 320 (21.7%) patients were treated with overlapping BRS (overlap group), whereas the remaining 1,157 (78.3%) received no-overlap BRS (no-overlap group). The overlap group had significantly higher frequency of male sex, diabetes mellitus, stable angina, B2/C lesion type, SYNTAX score ≥22, lesion length >34 mm, use of intracoronary imaging guidance, pre- and postdilatation. At 1-year, there were no differences in PoCE between the overlap versus no-overlap group (18.4% vs. 18.2%; HR 1.07, [0.80-1.44]; P = 0.636), even after adjustment (HR 1.05, [0.48-2.20]; P = 0.904). Scaffold thrombosis rate did not differ either at one-month (1.3% vs. 1.5%, P = 0.769) or at 1-year (1.9% vs. 2.1%, P = 0.823).
  
  
  CONCLUSIONS
  In "Real-world" clinical practice, overlapping BRS does not appear to have an impact on clinical outcomes as compared to no-overlapping BRS. These preliminary data should be confirmed. © 2016 Wiley Periodicals, Inc.
authors: Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
authors: Luis
authors: L
authors: Ortega-Paz
authors: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors: Davide
authors: D
authors: Capodanno
authors: Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
authors: Giuseppe
authors: G
authors: Giacchi
authors: Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors: Tommaso
authors: T
authors: Gori
authors: Department of Cardiology, University of Giessen, Giessen, Germany.
authors: Holger
authors: H
authors: Nef
authors: EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors: Azeem
authors: A
authors: Latib
authors: San Giovanni di Dio Hospital, Agrigento, Italy.
authors: Giuseppe
authors: G
authors: Caramanno
authors: Royal Brompton Hospital & Imperial College, London, United Kingdom.
authors: Carlo
authors: C
authors: Di Mario
authors: Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors: Christoph
authors: C
authors: Naber
authors: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors: Maciej
authors: M
authors: Lesiak
authors: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors: Piera
authors: P
authors: Capranzano
authors: Department of Cardiology, University of Giessen, Giessen, Germany.
authors: Jens
authors: J
authors: Wiebe
authors: Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilian Universität, Munich, Germany.
authors: Julinda
authors: J
authors: Mehilli
authors: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors: Aleksander
authors: A
authors: Araszkiewicz
authors: Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors: Stelios
authors: S
authors: Pyxaras
authors: Royal Brompton Hospital & Imperial College, London, United Kingdom.
authors: Alessio
authors: A
authors: Mattesini
authors: San Giovanni di Dio Hospital, Agrigento, Italy.
authors: Salvatore
authors: S
authors: Geraci
authors: EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors: Toru
authors: T
authors: Naganuma
authors: EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors: Antonio
authors: A
authors: Colombo
authors: Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors: Thomas
authors: T
authors: Münzel
authors: Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
authors: Manel
authors: M
authors: Sabaté
authors: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors: Corrado
authors: C
authors: Tamburino
authors: Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
authors: Salvatore
authors: S
authors: Brugaletta
mesh_terms: D020341:Absorbable Implants; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D054855:Drug-Eluting Stents; D005060:Europe / Q000453:epidemiology; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D054457:Tissue Scaffolds
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: bioresorbable scaffolds; bioresorbable vascular scaffolds; coronary artery disease; percutaneous coronary intervention