BACKGROUND There is a scarcity of data evaluating everolimuseluting bioresorbable scaffold BRS implantation in the setting of acute coronary syndrome (ACS). We sought to evaluate clinical and angiographic outcomes of patients with ACS undergoing BRS implantation, in comparison to patients with stable coronary artery disease (CAD). METHODS Consecutive patients undergoing implantation of everolimus- eluting BRS at two centers in Munich, Germany were enrolled and divided into 2 groups according to the indication for stenting: ACS vs. stable CAD. Angiographic surveillance was planned at 6-8 months. Clinical follow-up was performed up to 24 months. Primary endpoints of interest were the composite of death/myocardial infarction/target lesion revascularization, target lesion revascularization and definite scaffold thrombosis. RESULTS A total of 419 patients were enrolled, of which 163 had ACS and 256 stable CAD. Complex lesion morphology (B2/C) was observed in a similar proportion of patients in both groups (50.8 vs. 47.9%; p=0.52). Minimal lumen diameter was significantly smaller (0.75 vs 0.99mm; p<0.001) and pre-dilatation was significantly more often utilized (99.5 vs. 96.6%; P0=0.04) in the ACS group. Post-dilatation was less frequently performed (62.3 vs. 77.1%; p<0.001) in the ACS group. Angiographic surveillance showed that in-stent late luminal loss was lower in the ACS group (0.17 vs. 0.31mm; p=0.01). After 2 years the rates of the composite endpoint (19.8 vs. 24.0%, p=0.50), target lesion revascularization (15.5 vs. 17.4%, p=0.62) and definite scaffold thrombosis was similar in both groups (4.3 vs. 3.8%, p=0.75). CONCLUSION In selected patients with ACS undergoing BRS implantation clinical outcomes were similar to patients with stable CAD treated with BRS. In patients with angiographic surveillance data late lumen loss was lower in those with BRS implantation for ACS.
Wiebe, J., Harada, Y., Hoppmann, P., Colleran, R., Kufner, S., Xhepa, E., … Byrne, R. (2016). TCT-414 Two-year outcomes of patients with acute coronary syndrome versus stable coronary disease undergoing bioresorbable scaffold implantation. Journal of the American College of Cardiology, 68(18), B168. https://doi.org/10.1016/j.jacc.2016.09.549