Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis: final 7-year results of the COMPARE-ABSORB trial

Smits PC, Włodarczak A, Chevalier B, West NE, Gori T, Abdel-Wahab M, Barbato E, Esposito G, Tarantini G, Kocka V, Achenbach S, Dudek D, Escaned J, Tijssen JG, Rademaker-Havinga TA, Serruys P, Morice MC, Onuma Y, Geuns RJv, Behalf Of The Compare-Absorb Trial Investigators O (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 22

Pages Range: 243-254

Journal Issue: 4

DOI: 10.4244/EIJ-D-25-00778

Abstract

BACKGROUND: The clinical outcomes of bioresorbable vascular scaffolds (BVS) compared with everolimus-eluting stents (EES) beyond 5-year follow-up are unknown. AIMS: This study aims to investigate clinical outcomes of BVS 7 years after implantation. METHODS: The COMPARE-ABSORB trial is an investigator-initiated, prospective randomised study. Patients at high risk of restenosis were randomly assigned to receive either a BVS or an 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 (CI-TLR). The primary and co-primary objectives were non-inferiority at 1 year and superiority of BVS at 7 years after a 3-year landmark analysis. RESULTS: Although enrolment was stopped at 1,670 patients (80% of the intended 2,100 patients; 848 patients receiving BVS and 822 EES) because of high thrombosis and TVMI rates in the BVS arm, non-inferiority for TLF at 1 year was met. At 7-year follow-up subsequent to a 3-year landmark analysis, the TLF rate of BVS was 6.7% versus 5.9% for EES (hazard ratio [HR] 1.14, 95% confidence interval [CI]: 0.76-1.77; p=0.53); therefore, superiority was not met. Cardiac death, TVMI, and device thrombosis rates did not differ between both groups; however, CI-TLR was significantly higher in the BVS arm (4.4% vs 2.2%; HR 1.97, 95% CI: 1.08-3.60; p=0.023). CONCLUSIONS: After complete resorption, no benefit was observed with BVS compared with EES at 7-year follow-up, despite the use of a dedicated implantation protocol for BVS. In fact, after 3 years, more target lesion revascularisations occurred with BVS than with EES.

Authors with CRIS profile

Involved external institutions

Cardiovascular Institute Paris Sud (ICPS) France (FR) Royal Papworth Hospital NHS Foundation Trust United Kingdom (GB) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Segeberger Kliniken Germany (DE) Università degli studi "La Sapienza" Italy (IT) Università degli Studi di Napoli Federico II Italy (IT) University of Padua / Universita degli Studi di Padova Italy (IT) Fakultní nemocnice Královské Vinohrady Czech Republic (CZ) Jagiellonian University / Uniwersytet Jagielloński (UJ) Poland (PL) Universidad Complutense de Madrid (UCM) Spain (ES) Amsterdam University Medical Centers (Amsterdam UMC) / Amsterdam Universitair Medische Centra Netherlands (NL) Cardialysis Netherlands (NL) University of Galway (NUIG) / Ollscoil na Gaillimhe Ireland (IE) CERC Cardiovascular European Research Center France (FR) Maasstad Ziekenhuis Netherlands (NL) Wrocław University of Science and Technology / Politechnika Wrocławska Poland (PL) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) Netherlands (NL)

How to cite

APA:

Smits, P.C., Włodarczak, A., Chevalier, B., West, N.E., Gori, T., Abdel-Wahab, M.,... Behalf Of The Compare-Absorb Trial Investigators, O. (2026). Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis: final 7-year results of the COMPARE-ABSORB trial. EuroIntervention, 22(4), 243-254. https://doi.org/10.4244/EIJ-D-25-00778

MLA:

Smits, Pieter C., et al. "Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis: final 7-year results of the COMPARE-ABSORB trial." EuroIntervention 22.4 (2026): 243-254.

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