Three to four years outcomes of the absorb bioresorbable vascular scaffold versus second-generation drug-eluting stent: A meta-analysis

ObjectiveThis meta-analysis sought to evaluate the outcomes of absorb bioresorbable vascular scaffolds (BVS) compared with second-generation drug-eluting stents (DES) after 3years, the approximate time of complete polymer bioresorption. BackgroundBVS were found to be inferior to second-generation DES in early and mid-term outcomes with a higher rate of target vessel myocardial infarction (TV-MI) and device thrombosis (DT). Improper implantation techniques and incomplete bioresorption of the poly-l-lactide (PLLA) polymer were sighted as possible reasons. MethodsWe conducted an electronic database search for all randomized control trials that compared absorb BVS to second-generation DES and reported outcomes of interest after 3years of absorb BVS implantation. Assuming interstudy heterogeneity, a random-effects analysis was conducted with odds ratio as the effect size of choice to compare the event rates between the two groups. ResultsA total of four studies (n=3,245, BVS=2075, DES=1,170) were included in the final analysis. Pooled analysis revealed that there was no difference between absorb BVS and second-generation DES with respect to target lesion failure (TLF) (OR=1.23, 95% CI=0.73-2.07, p=0.44), TV-MI (OR=1.03, 95% CI=0.42-2.53, p=0.95), target lesion revascularization (TLR) (OR=1.61, 95% CI=0.77-3.33, p=0.20) and definite/probable DT (OR=0.71, 95% CI=0.10-5.07, p=0.74). Also, there was no difference in cardiac mortality (OR=0.66, 95% CI=0.22-1.94, p=0.45). ConclusionsBetween 3 and 4 years of follow-up, patients receiving absorb BVS did not have significantly different outcomes, in terms of TLF, TV-MI, TLR, DT, and cardiac mortality, compared to DES.