Twelve-month outcomes after bioresorbable vascular scaffold implantation in patients with acute coronary syndromes. Data from the European Multicenter GHOST-EU Extended Registry.
OBJECTIVE
The aim of this study was to report on the midterm outcomes of patients undergoing percutaneous coronary intervention with bioresorbable vascular scaffolds (BVS) for the treatment of acute coronary syndromes (ACS) and compare with those of patients with stable coronary artery disease (sCAD).


RESULTS
One thousand four hundred and seventy-seven (1,477) patients underwent implantation of one or more BVS (Absorb BVS; Abbott Vascular, Santa Clara, CA, USA) at 11 European centres and were included in the GHOST-EU registry. Admissions comprised 47.1% of the patients (951 BVS) with ACS, and 52.8% (1,274 BVS) with sCAD. During a median follow-up of 384 (359-460) days, patient-oriented endpoints (PoCE), including all-cause death, any infarction, any revascularisation, were recorded in 271 patients (12-month incidence in ACS patients: 18.5% vs. 11.6% in the sCAD group, p<0.001). Device-oriented composite endpoints (DoCE), cardiac death, target vessel infarction and target lesion revascularisation, were observed in 98 patients (12-month incidence of 4.2% in the sCAD group, 6.4% in the ACS group; p=0.052). The 12-month incidence of definite scaffold thrombosis was 2.6% in ACS patients and 0.8% in XIENCE patients (p=0.006). In multivariate analysis, ACS was a predictor of DoCE (HR: 2.26 [1.34-3.81], p=0.002), PoCE (HR: 1.71 [1.13-2.58], p=0.011), and stent thrombosis (HR: 2.51 [1.13-5.60], p=0.025). In contrast, the incidence of target lesion revascularisation was not different between groups. There was no difference in the incidence of any of these endpoints among the different clinical presentations (unstable angina, non-ST-elevation infarction and ST-elevation infarction).


CONCLUSIONS
PoCE, DoCE and scaffold thromboses were more frequent in ACS patients, without any difference among different forms of ACS.
Zentrum für Kardiologie I, Universitätsmedizin Mainz, University Medical Center, German Center for Cardiovascular Research (DZHK, Standort Rhein-Main), Mainz, Germany.
Boris
B
Schnorbus
Jens
J
Wiebe
Davide
D
Capodanno
Salvatore
S
Brugaletta
Salvatore
S
Geraci
Julinda
J
Mehilli
Azeem
A
Latib
Maciej
M
Lesiak
Christoph
C
Jensen
Alessio
A
Mattesini
Thomas
T
Münzel
Piera
P
Capranzano
Carlo
C
Di Mario
Christoph
C
Naber
Aleksander
A
Araszkiewicz
Antonio
A
Colombo
Giuseppe
G
Caramanno
Manel
M
Sabate
Corrado
C
Tamburino
Holger
H
Nef
Tommaso
T
Gori
D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D003324:Coronary Artery Disease / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D016896:Treatment Outcome