TY - JOUR
T1 - Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis
T2 - The COMPAREABSORB randomised clinical trial
AU - COMPARE ABSORB trial investigators
AU - Smits, P. C.
AU - Chang, Chun Chin
AU - Chevalier, Bernard
AU - West, Nick E.J.
AU - Gori, Tommaso
AU - Barbato, Emanuele
AU - Tarantin, Giuseppe
AU - Kocka, Victor
AU - Achenbach, Stephan
AU - Dudek, Dariusz
AU - Escaned, Javier
AU - Wlodarczak, Adrian
AU - Abdel-Wahab, Mohamed
AU - Esposito, Giovanni
AU - Tijssen, Jan G.P.
AU - Morice, M. C.
AU - Onuma, Yoshinobu
AU - Van Geuns, Robert Jan
PY - 2020
Y1 - 2020
N2 - Aims: The aim of this study was to investigate clinical outcomes of patients at high risk of restenosis after implantation of a bioresorbable vascular scaffold (BVS). Methods and results: The COMPARE-ABSORB trial was an investigator-initiated, prospective randomised study. Patients at high risk of restenosis were randomly assigned to receive either a BVS or an everolimus-eluting stent (EES). A dedicated implantation technique was recommended for BVS. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) or clinically indicated target lesion revascularisation at one year. The enrolment was discontinued prematurely because of a high thrombosis and TVMI rate in the BVS arm. A total of 1,670 patients were recruited (BVS 848 patients and EES 822 patients). TLF occurred in 43 patients (5.1%) of the BVS group and 34 patients (4.2%) of the EES group (absolute difference 0.9%, 95% confidence interval [CI]: -1.2%-3.0%, p non-inferiority <0.001). Definite or probable device thrombosis (2.0% vs 0.6%, hazard ratio [HR] 3.32, 95% CI: 1.22-8.99, p=0.012) and TVMI (4.0% vs 2.1%, HR 1.96, 95% CI: 1.10-3.51, p=0.02) were significantly higher in the BVS group than in the EES group. Conclusions: In patients at high risk of restenosis, non-inferiority of BVS compared with EES in terms of TLF was met at one year. BVS carried a higher risk of device thrombosis and TVMI than EES.
AB - Aims: The aim of this study was to investigate clinical outcomes of patients at high risk of restenosis after implantation of a bioresorbable vascular scaffold (BVS). Methods and results: The COMPARE-ABSORB trial was an investigator-initiated, prospective randomised study. Patients at high risk of restenosis were randomly assigned to receive either a BVS or an everolimus-eluting stent (EES). A dedicated implantation technique was recommended for BVS. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) or clinically indicated target lesion revascularisation at one year. The enrolment was discontinued prematurely because of a high thrombosis and TVMI rate in the BVS arm. A total of 1,670 patients were recruited (BVS 848 patients and EES 822 patients). TLF occurred in 43 patients (5.1%) of the BVS group and 34 patients (4.2%) of the EES group (absolute difference 0.9%, 95% confidence interval [CI]: -1.2%-3.0%, p non-inferiority <0.001). Definite or probable device thrombosis (2.0% vs 0.6%, hazard ratio [HR] 3.32, 95% CI: 1.22-8.99, p=0.012) and TVMI (4.0% vs 2.1%, HR 1.96, 95% CI: 1.10-3.51, p=0.02) were significantly higher in the BVS group than in the EES group. Conclusions: In patients at high risk of restenosis, non-inferiority of BVS compared with EES in terms of TLF was met at one year. BVS carried a higher risk of device thrombosis and TVMI than EES.
KW - Bioresorbable scaffold
KW - Drug-eluting stent
KW - Stent thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85094684391&partnerID=8YFLogxK
U2 - https://doi.org/10.4244/EIJ-D-19-01079
DO - https://doi.org/10.4244/EIJ-D-19-01079
M3 - Article
C2 - 32451321
SN - 1774-024X
VL - 16
SP - 645
EP - 653
JO - Eurointervention
JF - Eurointervention
IS - 8
ER -