AUTHOR=Wan Yan-di , Wang Da-yang , Deng Wen-qi , Lai Si-jia , Wang Xian 

TITLE=Bioresorbable scaffolds vs. drug-eluting stents on short- and mid-term target lesion outcomes in patients after PCI: A systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.949494

DOI=10.3389/fcvm.2022.949494

ISSN=2297-055X

ABSTRACT=Background
While current concerns about BRS centered on late or very late scaffold thrombosis, less attention had been paid to short- and mid-term clinical outcomes. This review aimed to compare the short- and mid-term outcomes between bioresorbable scaffolds (BRS) and drug-eluting stents (DES).
Methods
A systematic review of randomized controlled trials (RCTs) that compared BRS vs. DES was conducted by searching PubMed, Cochrane Library, Web of Science, CNKI, WanFang, and VIP database from inception until 19 April 2022 (language limited to English or Chinese). The primary outcome was target lesion failure (TLF) within 12 months, defined as a composite of target lesion revascularization (TLR), target vessel revascularization (TVR), target vessel myocardial infarction (TVMI), and cardiac death. The secondary outcomes were in-stent diameter stenosis (DS%) provided by intraluminal imaging. This study was registered with PROSPERO (CRD42022327966)
Results
A total of 13 studies were eligible and were included in this review (N=9702 patients). The follow-up duration ranged from 6 months to 1 year. A significantly higher rate of TLF (RR, 1.22, 95% CI [1.03,1.44]) driven by the higher rate of TVMI (RR, 1.39, 95% CI [1.09, 1.76]) was observed in BRS group than in DES group. The risk of TLR and cardiac death was similar between groups. Also, compared to the DES group, the BRS group had a significantly higher in-stent DS% within 1 year (MD=5.23, 95%CI [3.43,7.04]; I2=97%; P<0.00001).
Conclusions
BRS was associated with increased risk of target lesion failure within 1 year as compared with DES, driven by the increased rates of target vessel myocardial infarction. Also, the in-stent DS% seemed to be higher with BRS. Therefore, BRS was inferior to DES in terms of target lesion outcomes at short- or mid-term follow-up.