title: Bioresorbable scaffold implantation in patients with indication for oral anticoagulation: A propensity matched analysis.
abstract: OBJECTIVE
  To examine ischemic and bleeding outcomes in patients on triple antithrombotic therapy (TAT) compared with dual antiplatelet therapy (DAPT) after the implantation of bioresorbable scaffolds (BRS).
  
  
  BACKGROUND
  The optimal antithrombotic regimen in patients undergoing percutaneous coronary intervention that have an indication for oral anticoagulation is unclear, in particular among those undergoing BRS implantation.
  
  
  METHODS
  Consecutive patients of a single-center, all-comers BRS registry were included. Patients were followed up after 30days, 6 and 12months, and thereafter yearly. Outcome parameters were target vessel failure (TVF), major adverse cardiac events (MACE) including target lesion revascularization (TLR), scaffold thrombosis (ST), death, myocardial infarction, and any bleeding as defined by BARC. Patients on TAT were matched to patients on DAPT.
  
  
  RESULTS
  A total of 607 patients were included. Fifty-five patients receiving TAT were matched with 165 patients treated with DAPT. Acute coronary syndrome was an indication for coronary angiography in 50.9% vs 50.4% groups (p=0.97). Major adverse cardiac events occurred in 16.4% of TAT patients vs. 8.9% DAPT patients (p=0.12), TLR in 5.5% vs. 1.9% (p=0.17), ST in 3.6% vs. 1.9% (p=0.46), and TVF in 3.6 vs. 1.9% (p=0.46). Patients died in 7.3% in the TAT group vs. 5.1% in the DAPT group (p=0.26). No severe bleeding was recorded in either of the groups.
  
  
  CONCLUSIONS
  There was no difference in bleeding or ischemic events between the patients on TAT and those on DAPT after BRS implantation. The high rate of scaffold thrombosis in all of these patients, however, is not negligible.
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany.
authors.forename: Niklas F
authors.initials: NF
authors.lastname: Boeder
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany.
authors.forename: Victoria
authors.initials: V
authors.lastname: Johnson
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: Deutsches Herzzentrum München, Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Klinikum Oldenburg, Department of Cardiology, Oldenburg, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.affiliation: St. Johannes-Hospital, Department of Internal Medicine, Dortmund, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Nef
authors.affiliation: University of Giessen, Department of Cardiology, Giessen, Germany. Electronic address: bauer-timm@gmx.de.
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
mesh_terms: D020341:Absorbable Implants; D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000601:surgery*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D057216:Propensity Score; D011474:Prosthesis Design; D012042:Registries; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Antithrombotic therapy; Bioresorbable scaffold; Dual antiplatelet therapy; Oral anticoagulation; Triple therapy