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Whereas the effects of stent thrombosis in bare metal stents and drug eluting stents on mortality and myocardial infarction have been well documented in the literature, there are currently no reports of the effects of scaffold thrombosis on these outcomes of the newest stents in ABSORB bioresorbable vascular scaffolds. We sought to compare the effect on mortality and myocardial infarction (MI) of scaffold thrombosis with no occurrence of scaffold thrombosis in patients receiving an ABSORB bioresorbable vascular scaffold after percutaneous coronary intervention.
We conducted a systematic review in MEDLINE, EMBASE, Cochrane CENTRAL, and Google Scholar and subsequent meta-analysis of 13 studies (5 randomized controlled trials and 8 observational studies) reporting the clinical outcomes of mortality and myocardial infarction of scaffold thrombosis and no scaffold thrombosis to compare the risk and estimate the pooled incidence rates for these outcomes. Random effects model was used to generate pooled estimates, with presentation being of relative risk ratios (RR) with 95%-confidence intervals (CI).
There were a total of 6,676 patients included in this study, of which 131 patients experienced a scaffold thrombosis event (1.96%). The rate of death after a scaffold thrombosis event was 17.4%, whereas the rate of MI was 76.2%. Patients treated with an ABSORB bioresrobable vascular scaffold thrombosis were at a high risk for death after a scaffold thrombosis event (RR = 21.21; 95% CI = 9.42-47.78; p = 0.027) and MI (RR = 31.35; 95% CI = 20.90-47.04; p = 0.00).
As compared to patients having not undergone a scaffold thrombosis event, patients with a scaffold thrombosis event had a high rate of death and MI, comparable to rates and RRs seen with stent thrombosis reported in the literature.
CORONARY: Stents: Bioresorbable Vascular Scaffolds