In a nutshell
The aim of this study was to examine the long term effects of BVS.
This study concluded that the rate of device-related complications from BVS did not decline over time.
Some background
Percutaneous coronary intervention (PCI) is a non-surgical process that delivers a small structure called a stent to the coronary arteries that pump blood to the heart. The stent keeps the arteries open and prevents the plaque build-up from closing arteries. PCI is used when a patient is at risk of heart failure and aims to prevent it.
Drug-eluting stents (DES) are the standard stent used in PCI, but these permanent stents have drawbacks. Bioresorbable vascular scaffolds (BVS) are a newer type of stent. They help to keep the coronary artery open but dissolve over time. It was thought that the use of BVS could prevent long term stent-related complications.
There is a great deal of information regarding short and mid-term effects of BVS use. However, there is not much information on late-term effects of BVS use.
Methods & findings
This study involved 195 patients who had been treated with at least one BVS. Patients were followed for an average of 834 days. The device-oriented composite endpoint (DOCE) was a measurment of multiple outcomes, including death related to heart problems, myocardial infarction (MI, heart attack) and target lesion revascularization (TLR, a second surgery).
75% of patients who received BVS had acute coronary syndrome (ACS). ACS involves MI and/or angina (chest pain). Of the patients with ACS, 42.9% had ST-elevation MI (severe) and 40.8% had non-ST-elevation MI (less severe).
DOCE was found in 15.4% of patients by the end of the follow-up. In 36.7% of these patients, DOCE occured before 12 months had passed. The average time until DOCE occurred was 211.5 days.
The use of a stent had increased risks for TLR and DOCE. Patients who did not have ACS were 11.8 times more likely to have TLR and 2 times more likely to have DOCE. ACS patients were 10.4 times more likely to have TLR and 2.4 times more likely to have DOCE.
The bottom line
This study concluded that the rate of device-related complications from BVS did not decline over time and patients with and without ACS had similar rate of risks.
The fine print
Larger studies are needed to confirm the findings.
What’s next?
Consult your physician about the different types of stents available to you.
Published By :
International Journal of Cardiology
Date :
Feb 21, 2017
