Angina and Ischemia at 2 Years With Bioresorbable Vascular Scaffolds and Metallic Drug-eluting Stents. ESTROFA Ischemia BVS-mDES Study

Rev Esp Cardiol (Engl Ed). 2018 May;71(5):327-334. doi: 10.1016/j.rec.2017.03.024. Epub 2017 Apr 29.
[Article in English, Spanish]

Abstract

Introduction and objectives: Bioresorbable vascular scaffolds (BVS) have the potential to restore vasomotion but the clinical implications are unknown. We sought to evaluate angina and ischemia in the long-term in patients treated with BVS and metallic drug-eluting stents (mDES).

Methods: Multicenter study including patients with 24 ± 6 months of uneventful follow-up, in which stress echocardiography was performed and functional status was assessed by the Seattle Angina Questionnaire (SAQ). The primary endpoint was a positive result in stress echocardiography.

Results: The study included 102 patients treated with BVS and 106 with mDES. There were no differences in the patients' baseline characteristics. Recurrent angina was found in 18 patients (17.6%) in the BVS group vs 25 (23.5%) in the mDES group (P = .37), but SAQ results were significantly better in the BVS group (angina frequency 96.0 ± 8.0 vs 89.2 ± 29.7; P = .02). Stress echocardiography was positive in 11/92 (11.9%) of BVS patients vs 9/96 (9.4%) of mDES patients in the (P = .71) and angina was induced in 2/102 (1.9%) vs 7/106 (6.6%) (P = .18), respectively, but exercise performance was better in the BVS group even in those with positive tests (exercise duration 9.0 ± 2.0minutes vs 7.7 ± 1.8minutes; P = .02). A propensity score matching analysis yielded similar results.

Conclusions: The primary endpoint was similar in both groups. In addition, recurrent angina was similar in patients with BVS and mDES. The better functional status, assessed by means of SAQ and exercise performance, detected in patients receiving BVS should be confirmed in further studies.

Keywords: Angina; Armazón bioabsorbible; Bioresorbable scaffold; Drug-eluting stent; Ecografía de estrés; Ischemia; Isquemia; Stent farmacoactivo; Stress echocardiography.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Absorbable Implants
  • Aged
  • Angina Pectoris / diagnosis
  • Angina Pectoris / therapy*
  • Cohort Studies
  • Drug-Eluting Stents*
  • Echocardiography, Stress / methods*
  • Electrocardiography / methods
  • Everolimus / pharmacology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / therapy*
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / methods
  • Propensity Score
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Tertiary Care Centers
  • Time Factors
  • Tissue Scaffolds*
  • Treatment Outcome

Substances

  • Metals
  • Everolimus