In a nutshell
This study aimed to compare the effectiveness of everolimus (Afinitor) eluting bioresorbable stents and everolimus eluting metallic stents in patients undergoing percutaneous coronary intervention.
This study concluded that there was there was no difference in effectiveness between the two stent types in patients undergoing percutaneous coronary intervention.
Some background
Percutaneous coronary intervention (PCI) is a non-surgical method of treatment for patients who have had heart attacks or are at risk of heart attacks. PCI uses a small tube called a stent to keep the coronary arteries open, to allow blood flow in arteries that have a build-up of plaque. PCI reduces the chance of a heart attack occurring.
Two types of stents that are commonly used are bioresorbable vascular scaffolds (BVS) and drug-eluting metallic stents (MS). The stents are coated in drugs to help prevent scar tissue formation. Everolimus is one type of drug that is used to coat these stents.
It was not known if one of these types of stents had an advantage over the other.
Methods & findings
This study involved 1845 patients undergoing PCI. 51% of these patients received the everolimus BVS and 49% received the everolimus MS. Patients were followed for an average of 707 days and target vessel failure (TVF) and device thrombosis were measured. TVF includes heart attacks and heart related deaths. Device thrombosis is the formation of blood clots due to the insertion of stents.
Target vessel failure occurred in 11.7% of the BVS group compared to 10.7% in the MS group.
Heart related deaths occurred in 2% of the BVS group compared to 2.7% in the MS group.
Target vessel related heart attacks occurred in 5.5% of the BVS group compared to 3.2% in the MS group.
Device thrombosis occurred in 3.5% of the BVS group compared to 0.9% in the MS group.
The bottom line
This study concluded that there were no significant differences between the two stent types in relation to the rate of target vessel failure. The study also concluded that BVS patients had an increased rate of device thrombosis when compared to MS patients.
The fine print
The limitation to this study is that the follow up only lasted an average of two years. Longer follow up periods need to take place.
This study was funded by Abbott Vascular.
What’s next?
Consult your physician about stent options that are suitable for you.
Published By :
The New England Journal of Medicine
Date :
Mar 29, 2017
