PLoS ONE (Jan 2018)

Mid-term outcomes of the Absorb BVS versus second-generation DES: A systematic review and meta-analysis.

  • Cordula M Felix,
  • Victor J van den Berg,
  • Sanne E Hoeks,
  • Jiang Ming Fam,
  • Mattie Lenzen,
  • Eric Boersma,
  • Peter C Smits,
  • Patrick W Serruys,
  • Yoshinobu Onuma,
  • Robert Jan M van Geuns

DOI
https://doi.org/10.1371/journal.pone.0197119
Journal volume & issue
Vol. 13, no. 5
p. e0197119

Abstract

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Bioresorbable Vascular Scaffolds (BVS) were introduced to overcome some of the limitations of drug-eluting stent (DES) for PCI. Data regarding the clinical outcomes of the BVS versus DES beyond 2 years are emerging.To study mid-term outcomes.We searched online databases (PubMed/Medline, Embase, CENTRAL), several websites, meeting presentations and scientific session abstracts until August 8th, 2017 for studies comparing Absorb BVS with second-generation DES. The primary outcome was target lesion failure (TLF). Secondary outcomes were all-cause mortality, myocardial infarction, target lesion revascularization (TLR) and definite/probable device thrombosis. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived using a random effects model.Ten studies, seven randomized controlled trials and three propensity-matched observational studies, with a total of 7320 patients (BVS n = 4007; DES n = 3313) and a median follow-up duration of 30.5 months, were included. Risk of TLF was increased for BVS-treated patients (OR 1.34 [95% CI: 1.12-1.60], p = 0.001, I2 = 0%). This was also the case for all myocardial infarction (1.58 [95% CI: 1.27-1.96], p1 year) device thrombosis was 6.10 [95% CI: 1.40-26.65], p = 0.02).At mid-term follow-up, BVS was associated with an increased risk of TLF, MI, TLR and definite/probable device thrombosis, but this did not result in an increased risk of all-cause mortality.