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Five-Year Outcomes of Bioresorbable Stent Therapy for Coronary Heart Disease: A Systematic Review and Meta-Analysis

Fei-Fei Yang1, Hui Song1, Wei-Bin Qin2

  • 1Graduate School, Guangxi University of Chinese Medicine, 530000 Nanning, Guangxi, China.

Reviews in Cardiovascular Medicine
|August 14, 2024
PubMed

Insights

Bioresorbable vascular scaffolds (BVS) show similar cardiac mortality to metallic stents after five years. However, BVS have higher rates of revascularization, thrombosis, and failure, indicating significant drawbacks for coronary heart disease treatment.

Area of Science:

  • Cardiovascular Medicine
  • Biomaterials Science
  • Interventional Cardiology

Background:

  • The long-term efficacy of bioresorbable vascular scaffolds (BVS) versus metallic stents for coronary heart disease is debated.
  • A comprehensive review of five-year clinical outcomes for BVS is lacking.
  • This study addresses the controversy by analyzing five-year results from randomized controlled trials.

Purpose of the Study:

  • To systematically review and meta-analyze five-year clinical outcomes of bioresorbable vascular scaffolds (BVS) compared to metallic stents.
  • To evaluate the comparative safety and efficacy of BVS in treating coronary heart disease.
  • To provide evidence-based insights into the long-term performance of BVS.

Main Methods:

  • Systematic literature search of databases from inception to June 30th, 2023.
  • Inclusion of high-quality randomized controlled trials with low risk of bias.
  • Meta-analysis of clinical outcomes at the five-year follow-up point.

Main Results:

  • Five high-quality randomized controlled trials were included in the meta-analysis.
  • At five years, bioresorbable stents demonstrated comparable cardiac mortality rates to metallic stents.
  • Bioresorbable stents showed inferior outcomes regarding lesion revascularization, in-stent thrombosis, target lesion failure, target vessel failure, and myocardial infarction.

Conclusions:

  • Bioresorbable vascular scaffolds (BVS) are comparable to metallic stents concerning cardiac mortality at five years.
  • Significant drawbacks, including higher rates of revascularization and adverse events, necessitate careful clinical consideration for BVS use.
  • The findings suggest that metallic stents may remain the preferred option for certain patient populations due to superior long-term safety and efficacy profiles.
Abstract

Keywords:
bioresorbable stentcoronary heart diseasefive-year outcomesmeta-analysissystematic review

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