Predictors of early scaffold thrombosis: results from the multicenter prospective German-Austrian ABSORB RegIstRy

Woehrle J, Nef HM, Naber C, Achenbach S, Riemer T, Mehilli J, Muenzel T, Schneider S, Markovic S, Seeger J, Rottbauer W, Pfannebecker T, Richardt G, Zahn R, Gori T, Kastner J, Schmermund A, Hamm CW (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Coronary Artery Disease Lippincott, Williams & Wilkins

Book Volume: 29

Pages Range: 389-396

Journal Issue: 5

DOI: 10.1097/MCA.0000000000000618

Abstract

BACKGROUND: In randomized clinical trials, the risk of thrombotic events with the absorb bioresorbable vascular scaffold (BVS) was significantly higher than with metallic drug-eluting stents. We evaluated predictors of scaffold thrombosis in the large-scale, multicenter German-Austrian ABSORB RegIstRy. METHODS AND RESULTS: 3178 patients with treatment of 4252 lesions using 5020 scaffolds were included. Follow-up rate at 6 months was 97.4%. Forty-five (1.42%) patients experienced definite/probable scaffold thrombosis during follow-up. Multiple regression analysis showed implantation of absorb BVS in bifurcation lesions [odds ratio (OR): 4.43; 95% confidence interval (CI): 1.69-11.59; P=0.0024] or treatment in the years 2013/2014 (OR: 1.88; 95% CI: 1.02-3.47; P=0.04) to be significant predictors of scaffold thrombosis. Excluding bifurcation lesions, the incidence of definite/probable scaffold thrombosis decreased from 1.8% (95% CI: 1.17-2.64%) in 2013/2014 to 0.89% (95% CI: 0.5-1.46%) in 2015/2016. In the latter period, absorb BVS were implanted more often in younger patients with less complex de novo lesions, and debulking devices and postdilatation were used more frequently. Between the two treatment periods, there was a significant reduction in myocardial infarction (2.73-1.24%, P<0.01; OR: 0.45; 95% CI: 0.26-0.77), definite/probable scaffold thrombosis (1.79-0.88%, P<0.05; OR: 0.49; 95% CI: 0.26-0.93), and target lesion failure and revascularization during follow-up. CONCLUSION: Improved procedural technique and more strict patient selection may explain a significant decrease in the absorb BVS thrombosis rates during the recruitment period of the large-scale German-Austrian ABSORB RegIstRy. In addition, treatment of bifurcation lesions was identified as an independent predictor of definite/probable scaffold thrombosis.

Authors with CRIS profile

Stephan Achenbach Department of Medicine 2 – Cardiology and Angiology

Involved external institutions

Universitätsklinikum Ulm DE Germany (DE) Justus-Liebig-Universität Gießen DE Germany (DE) Elisabeth-Krankenhaus Essen DE Germany (DE) IHF GmbH Institut für Herzinfarktforschung DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) DE Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz DE Germany (DE) Abbott GmbH & Co. KG DE Germany (DE) Segeberger Kliniken DE Germany (DE) Klinikum der Stadt Ludwigshafen am Rhein gGmbH DE Germany (DE) Medizinische Universität Wien AT Austria (AT) Centrum für Hämatologie und Onkologie Bethanien DE Germany (DE)

How to cite

APA:

Woehrle, J., Nef, H.M., Naber, C., Achenbach, S., Riemer, T., Mehilli, J.,... Hamm, C.W. (2018). Predictors of early scaffold thrombosis: results from the multicenter prospective German-Austrian ABSORB RegIstRy. Coronary Artery Disease, 29(5), 389-396. https://dx.doi.org/10.1097/MCA.0000000000000618

MLA:

Woehrle, Jochen, et al. "Predictors of early scaffold thrombosis: results from the multicenter prospective German-Austrian ABSORB RegIstRy." Coronary Artery Disease 29.5 (2018): 389-396.

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