One-year efficacy and safety of everolimuseluting bioresorbable scaffolds in the setting of acute myocardial infarction

• Type of Material: Article
• Authors: Yongcheol Kim, Yonsei University; Sung A. Bae, Chonnam National University Hospital; Myung Ho Jeong, Chonnam National University Hospital; Youngkeun Ahn, Chonnam National University Hospital; Chong Jun Kim, Kyung Hee University Hospital; Myeong Chan Cho, Chungbuk National University Hospital; Andreas Baumbach, Queen Mary University of London; Bill D. Gogas, Nanjing Medical University; Spencer King, Emory University
• Language: English
• Date: 2020-07-01
• Publisher: The Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Kim et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0235673
• Title of Journal or Parent Work: PLoS ONE
• Volume: 15
• Issue: 7
• Start Page: e0235673
• End Page: e0235673
• Grant/Funding Information: It was supported by a grant from Chonnam National University Hospital Biomedical Research Institute (BCRI18015) and from the Korean Health Technology R & D Project (HI13C1527), sponsored by the Ministry of Health and Welfare, Republic of Korea.
• Keywords: Adult; Acute Disease; Proportional Hazards Models; Republic of Korea; Absorbable Implants; Percutaneous Coronary Intervention; Female; Drug-Eluting Stents; Treatment Outcome; Male; Tissue Scaffolds; Humans; Cardiovascular Agents; Middle Aged; Thrombosis; Endpoint Determination; Everolimus; Myocardial Infarction; Aged
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

Background and objectives: This study sought to compare clinical outcomes between bioresorbable scaffolds (BRS) and durable polymer everolimus-eluting metallic stents (DP-EES) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI). Methods: From March 2016 to October 2017, 952 patients with AMI without cardiogenic shock undergoing successful PCI with BRS (n = 136) or DP-EES (n = 816) were enrolled from a multicenter, observational Korea Acute Myocardial Infarction Registry. Results: In the crude population, there was no significant difference in the 1-year rate of device-oriented composite endpoint (DOCE) and device thrombosis between the BRS and DP-EES groups (2.2% vs. 4.8%, hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.13-1.41, p = 0.163; 0.7% vs. 0.5%, HR 1.49, 95% CI 0.16-13.4, p = 0.719, respectively). BRS implantation was opted in younger patients (53.7 vs. 62.6 years, p < 0.001) with low-risk profiles, and intravascular image-guided PCI was more preferred in the BRS group (60.3% vs. 27.2%, p < 0.001). Conclusions: At 1-year follow-up, no differences in the rate of DOCE and device thrombosis were observed between patients with AMI treated with BRS and those treated with DP-EES. Our data suggest that imaging-guided BRS implantation in young patients with low risk profiles could be a reasonable strategy in the setting of AMI.