Long-term follow-up and predictors of target lesion failure after implantation of everolimus-eluting bioresorbable scaffolds in real-world practice

Wiebe, Jens; Baquet, Moritz; Doerr, Oliver; Hoppmann, Petra; Jochheim, David; Rheude, Tobias; Boeder, Niklas; Grundman, David; Blachutzik, Florian; Theiss, Hans; Cassese, Salvatore; Hofmann, Felix J.; Gschwendtner, Sarah; Elsaesser, Albrecht; Massberg, Steffen; Hamm, Christian; Laugwitz, Karl-Ludwig; Byrne, Robert A.; Mehilli, Julinda; Kastrati, Adnan und Nef, Holger (2020): Long-term follow-up and predictors of target lesion failure after implantation of everolimus-eluting bioresorbable scaffolds in real-world practice. In: International Journal of Cardiology, Bd. 312: S. 42-47

Abstract

Background: Bioresorbable scaffolds (BRS) have been shown to be inferior to drug-eluting stents in randomized trials. Nevertheless, patients treated during daily routine differ from those treated within randomized trials and thus need further long-term evaluation. The present investigation aims to address this lack. Methods: Consecutive patientswith coronary artery disease treatedwith implantation of everolimus-eluting BRS at 5 centers in Germany were included. Clinical follow-up was assessed up to 3 years. Analysis of clinical outcomes was performed by pooling of the individual patient data sets of each center. The major clinical endpoints of interestwas target lesion failure (TLF) a composite of cardiac death, target vesselmyocardial infarction and target lesion revascularization. Furthermore occurrence of definite scaffold thrombosis was evaluated. A multivariable Cox regression analysis was applied to identify independent predictors of TLF. Results: A total of 1614 patients treated with BRS were analyzed (mean age 64.0 +/- 10.9 years, 75.8% male, 28.3% diabetics). A total 1817 lesions were treated with BRS and 56.0% were considered to be complex. At 3 years, the rate of TLF was 17.1% and definite scaffold thrombosis was noted in 2.6%. Independent predictors of TLF were a higher age, diabetes, bifurcation, complex lesions and the use of small BRS. Conclusions: In this large-scale analysis of patients undergoing BRS implantation in daily routine, event rateswere high, but in line with randomized studies. Predictors of TLF were identified which may optimize patient and lesion selection for BRS. (c) 2020 Elsevier B.V. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0167-5273
• Sprache: Englisch