Are BVS suitable for ACS patients? Support from a large single center real live registry

Objectives To investigate one-year outcomes after implantation of a bioresorbable vascular scaffold (BVS) in patients presenting with acute coronary syndrome (ACS) compared to stable angina patients. Background Robust data on the outcome of BVS in the setting of ACS is still scarce. Methods Two investigator initiated, single-center, single-arm BVS registries have been pooled for the purpose of this study, namely the BVS Expand and BVS STEMI registries. Results From September 2012-October 2014, 351 patients with a total of 428 lesions were enrolled. 255 (72.6%) were ACS patients and 99 (27.4%) presented with stable angina/silent ischemia. Mean number of scaffold/patient was 1.55 ± 0.91 in ACS group versus 1.91 ± 1.11 in non-ACS group (P = 0.11). Pre- and post-dilatation were performed less frequent in ACS patients, 75.7% and 41.3% versus 89.0% and 62.0% respectively (P = 0.05 and P = 0.001). Interestingly, post-procedural acute lumen gain and percentage diameter stenosis were superior in ACS patients, 1.62 ± 0.65 mm (versus 1.22 ± 0.49 mm, P < 0.001) and 15.51 ± 8.47% (versus 18.46 ± 9.54%, P = 0.04). Major adverse cardiac events (MACE) rate at 12 months was 5.5% in the ACS group (versus 5.3% in stable group, P = 0.90). One-year definite scaffold thrombosis rate was comparable: 2.0% for ACS population versus 2.1% for stable population (P = 0.94), however, early scaffold thromboses occurred only in ACS patients. Conclusions One-year clinical outcomes in ACS patients treated with BVS were similar to non-ACS patients. Acute angiographic outcomes were better in ACS than in non-ACS, yet the early thrombotic events require attention and further research.

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