PT - JOURNAL ARTICLE AU - Mohamed Farag AU - Nikolaos Spinthakis AU - Diana A Gorog AU - Abhiram Prasad AU - Keith Sullivan AU - Zaki Akhtar AU - Neville Kukreja AU - Manivannan Srinivasan TI - Use of bioresorbable vascular scaffold: a meta-analysis of patients with coronary artery disease AID - 10.1136/openhrt-2016-000462 DP - 2016 Aug 01 TA - Open Heart PG - e000462 VI - 3 IP - 2 4099 - http://openheart.bmj.com/content/3/2/e000462.short 4100 - http://openheart.bmj.com/content/3/2/e000462.full SO - Open Heart2016 Aug 01; 3 AB - Background Differences in outcomes between bioresorbable vascular scaffold (BVS) systems and drug-eluting metal stents (DES) have not been fully evaluated. We aimed to compare clinical and angiographic outcomes in randomised studies of patients with coronary artery disease (CAD), with a secondary analysis performed among registry studies.Methods A meta-analysis comparing outcomes between BVS and DES in patients with CAD. Overall estimates of treatment effect were calculated with random-effects model and fixed-effects model.Results In 6 randomised trials (3818 patients), BVS increased the risk of subacute stent thrombosis (ST) over and above DES (OR 2.14; CI 1.01 to 4.53; p=0.05), with a trend towards an increase in the risk of myocardial infarction (MI) (125 events in those assigned to BVS and 50 to DES; OR 1.36; CI 0.97 to 1.91; p=0.07). The risk of in-device late lumen loss (LLL) was higher with BVS than DES (mean difference 0.08 mm; CI 0.03 to 0.13; p=0.004). There was no difference in the risk of death or target vessel revascularisation (TVR) between the two devices. In 6 registry studies (1845 patients), there was no difference in the risk of death, MI, TVR or subacute ST between the two stents. Final BVS dilation pressures were higher in registry than in randomised studies (18.7±4.6 vs 15.2±3.3 atm; p<0.001).Conclusions Patients treated with BVS had an increased risk of subacute ST and slightly higher LLL compared with those with DES, but this might be related to inadequate implantation techniques, in particular device underexpansion.