Meta-analysis on the Safety and Efficacy of Absorb Bioresorbable Vascular Scaffold Versus Everolimus Eluting Stent for Percutaneous Coronary Intervention / 中国循环杂志

ABSTRACT

Objectives:To systemically review the safety and efficacy of bioresorbable vascular scaffold (BVS) versus everolimus eluting stent (EES) for percutaneous coronary intervention (PCI). Methods:The database searched includes PubMed, Medline, MEDILINE, EMBASE, Cochrane library, CNKI and Wanfang. Database retrieval time was between database establishment time to October 2017. During the same time, authors accessed the conference summary and related websites to collect published randomized controlled trials of published data. To evaluate the quality of the literature according to the modified Jadad scale and extracted the data. Meta-analysis was performed using Review Manager 5.3 software. Results:Nine trials were included; 6 721 patients were randomized to receive BVS (n=3 670) or EES (n=3 051). Time of follow-up was ranged from 6 to 36 months. Compared with metallic EES, risk of target lesion failure (RR=1.31, 95%CI1.08-1.58; P=0.005) and in-stent thrombosis (RR=2.89, 95%CI1.85-4.53; P＜0.0001), ischemia-driven target lesion revascularization (RR=1.44,95%CI1.12-1.86, P=0.005)、target-vessel myocardial infarction (RR=1.74, 95%CI1.33-2.27, P＜0.0001) and all myocardial infarction (RR=1.49, 95%CI1.16-1.91, P=0.002) were all significantly higher in BVS group than in EES group. There were no significant differences in all-cause death (RR=0.87, 95 % CI0.57-1.33, P=0.520), cardiovascular mortality (RR=0.78, 95%CI0.54-1.11, P=0.160) and composite endpoints (RR=1.10, 95%CI0.95-1.27, P=0.210) between the two groups. Conclusions:Compared with metallic EES, the BVS appears to be associated with both lower efficacy and higher thrombotic risk during the observation period.