M9. Five–year Outcome of Bioresorbable Vascular Scaffold versus Drug-Eluting Stent for Coronary Artery Disease: A Meta-Analysis of Randomized Control Trial

Abstract

Introduction Late stent thrombosis and restenosis remain major drawbacks of Drug-Eluting Stent (DES). Therefore, Bioresorbable Vascular Scaffolds (BVS) were created to combat these disadvantages. However, the long-term outcome of BVS versus DES for treating coronary artery disease remains inconclusive. Method We performed an orderly literature search from several electronic databases. We used the keyword “bioresorbable vascular scaffold” and “drug-eluting stent”. The inclusion criteria were comparing BVS and DES, Randomized Control Trial (RCT), and reported 5-year follow-up. The primary endpoints were cardiac death and stent thrombosis. Secondary endpoints were ischemic-driven target lesion revascularization (ID–TLR) and target lesion failure (TLF) as a composite of cardiac death, target vessel myocardial infarction (TVMI), or ID–TLR. Risk ratio (RR) with 95% confidence intervals (CIs) were used to report all outcomes. Results A total of 3 RCT were selected (ABSORB II, ABSORB III, and ABSORB JAPAN) with 2.890 patients were pooled in our analysis. At five years, compared to DES, BVS had no significant difference in cardiac death (RR = 0.81 [95% CI, 0.50-1.32], p = 0.40). However, BVS had higher risk of stent thrombosis (RR = 2.74 [95% CI, 1.38-5.46], p = 0.004), ID–TLR (RR = 1.38 [95% CI, 1.04-1.84], p = 0.03) and TLF (RR = 1.26 [95% CI, 1.03-1.54], p = 0.02). Conclusions Comparing to DES, BVS has a significantly greater risk of stent thrombosis, ID–TLR, and TLF after five years of follow-up.