Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry)

Elisabetta Moscarella, Alfonso Ielasi, Attilio Varricchio, Maria Carmen De Angelis, Bruno Loi, Giuseppe Tarantini, Paolo Calabrò, Bernardo Cortese, Pietro Mazzarotto, Gabriele Gabrielli, Francesco Pisano, Michela Facchin, Leonardo Misuraca, Valerio Lucci, Roberto Gistri, Gabriele Tumminello, Luciano Moretti, Alessandro Colombo, Alessandro Durante, Massimo FineschiDavide Piraino, Maurizio Ferrario, Sebastian Coscarelli, Annamaria Nicolino, Maurizio Tespili, Donatella Corrado, Giuseppe Steffenino

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The bioresorbable vascular scaffold (BVS) technology may be an appealing option in ST-segment elevation myocardial infarction (STEMI) patients. However, the available evidence on its use in this challenging subset is limited. Methods: Registro Absorb Italiano (RAI) is a multicenter, prospective registry that aims to assess BVS performance through a 5-year follow-up of all consecutive patients who undergone at least 1 successful BVS implantation. As a part of it, a subgroup analysis in STEMI patients was performed and the outcomes of this cohort compared to the remaining population (defined as “non-STEMI”) are reported here. Results: Among the 1505 patients enrolled, 317 (21.1%) had STEMI on admission. Among those, 232 (73.2%) underwent primary percutaneous coronary intervention (PCI) within 12 h from symptom onset; 64 (20.2%) were late-comers (>12 h); 16 (5%) underwent PCI after successful thrombolysis while 5 (1.6%) underwent rescue-PCI. At a median follow-up time of 12 months (IQR 6–20 months) no differences were noticed between STEMI and “non-STEMI” groups in terms of device-oriented composite endpoint (4.1% vs. 5.6%; p = 0.3) and its singular components: ischemia-driven target lesion revascularization (3.2% vs. 3.6%; p = 0.7), target-vessel myocardial infarction (3.2% vs. 2.8%; p = 0.7) and cardiac death (0.6% vs. 0.6%; p = 0.9). The rate of definite/probable scaffold thrombosis (ScT) was numerically higher but not significant in the STEMI group (2.5% vs. 1.3%; p = 0.1). Conclusions: BVS implantation in an unrestricted cohort of STEMI patients is associated with a numerically higher rate of ScT compared to the non-STEMI group. Further studies exploring the potential clinical impact of a pre-specified BVS implantation strategy in this high-risk clinical setting are needed.

Original languageEnglish
Pages (from-to)50-54
Number of pages5
JournalInternational Journal of Cardiology
Volume258
DOIs
Publication statusPublished - May 1 2018

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Blood Vessels
Registries
Myocardial Infarction
Percutaneous Coronary Intervention
Thrombosis
ST Elevation Myocardial Infarction
Ischemia
Technology
Equipment and Supplies
Population

Keywords

  • Bioresorbable vascular scaffolds
  • Percutaneous coronary interventions
  • STEMI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry). / Moscarella, Elisabetta; Ielasi, Alfonso; Varricchio, Attilio; De Angelis, Maria Carmen; Loi, Bruno; Tarantini, Giuseppe; Calabrò, Paolo; Cortese, Bernardo; Mazzarotto, Pietro; Gabrielli, Gabriele; Pisano, Francesco; Facchin, Michela; Misuraca, Leonardo; Lucci, Valerio; Gistri, Roberto; Tumminello, Gabriele; Moretti, Luciano; Colombo, Alessandro; Durante, Alessandro; Fineschi, Massimo; Piraino, Davide; Ferrario, Maurizio; Coscarelli, Sebastian; Nicolino, Annamaria; Tespili, Maurizio; Corrado, Donatella; Steffenino, Giuseppe.

In: International Journal of Cardiology, Vol. 258, 01.05.2018, p. 50-54.

Research output: Contribution to journalArticle

Moscarella, E, Ielasi, A, Varricchio, A, De Angelis, MC, Loi, B, Tarantini, G, Calabrò, P, Cortese, B, Mazzarotto, P, Gabrielli, G, Pisano, F, Facchin, M, Misuraca, L, Lucci, V, Gistri, R, Tumminello, G, Moretti, L, Colombo, A, Durante, A, Fineschi, M, Piraino, D, Ferrario, M, Coscarelli, S, Nicolino, A, Tespili, M, Corrado, D & Steffenino, G 2018, 'Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry)', International Journal of Cardiology, vol. 258, pp. 50-54. https://doi.org/10.1016/j.ijcard.2018.01.135
Moscarella, Elisabetta ; Ielasi, Alfonso ; Varricchio, Attilio ; De Angelis, Maria Carmen ; Loi, Bruno ; Tarantini, Giuseppe ; Calabrò, Paolo ; Cortese, Bernardo ; Mazzarotto, Pietro ; Gabrielli, Gabriele ; Pisano, Francesco ; Facchin, Michela ; Misuraca, Leonardo ; Lucci, Valerio ; Gistri, Roberto ; Tumminello, Gabriele ; Moretti, Luciano ; Colombo, Alessandro ; Durante, Alessandro ; Fineschi, Massimo ; Piraino, Davide ; Ferrario, Maurizio ; Coscarelli, Sebastian ; Nicolino, Annamaria ; Tespili, Maurizio ; Corrado, Donatella ; Steffenino, Giuseppe. / Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry). In: International Journal of Cardiology. 2018 ; Vol. 258. pp. 50-54.
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T1 - Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry)

AU - Moscarella, Elisabetta

AU - Ielasi, Alfonso

AU - Varricchio, Attilio

AU - De Angelis, Maria Carmen

AU - Loi, Bruno

AU - Tarantini, Giuseppe

AU - Calabrò, Paolo

AU - Cortese, Bernardo

AU - Mazzarotto, Pietro

AU - Gabrielli, Gabriele

AU - Pisano, Francesco

AU - Facchin, Michela

AU - Misuraca, Leonardo

AU - Lucci, Valerio

AU - Gistri, Roberto

AU - Tumminello, Gabriele

AU - Moretti, Luciano

AU - Colombo, Alessandro

AU - Durante, Alessandro

AU - Fineschi, Massimo

AU - Piraino, Davide

AU - Ferrario, Maurizio

AU - Coscarelli, Sebastian

AU - Nicolino, Annamaria

AU - Tespili, Maurizio

AU - Corrado, Donatella

AU - Steffenino, Giuseppe

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: The bioresorbable vascular scaffold (BVS) technology may be an appealing option in ST-segment elevation myocardial infarction (STEMI) patients. However, the available evidence on its use in this challenging subset is limited. Methods: Registro Absorb Italiano (RAI) is a multicenter, prospective registry that aims to assess BVS performance through a 5-year follow-up of all consecutive patients who undergone at least 1 successful BVS implantation. As a part of it, a subgroup analysis in STEMI patients was performed and the outcomes of this cohort compared to the remaining population (defined as “non-STEMI”) are reported here. Results: Among the 1505 patients enrolled, 317 (21.1%) had STEMI on admission. Among those, 232 (73.2%) underwent primary percutaneous coronary intervention (PCI) within 12 h from symptom onset; 64 (20.2%) were late-comers (>12 h); 16 (5%) underwent PCI after successful thrombolysis while 5 (1.6%) underwent rescue-PCI. At a median follow-up time of 12 months (IQR 6–20 months) no differences were noticed between STEMI and “non-STEMI” groups in terms of device-oriented composite endpoint (4.1% vs. 5.6%; p = 0.3) and its singular components: ischemia-driven target lesion revascularization (3.2% vs. 3.6%; p = 0.7), target-vessel myocardial infarction (3.2% vs. 2.8%; p = 0.7) and cardiac death (0.6% vs. 0.6%; p = 0.9). The rate of definite/probable scaffold thrombosis (ScT) was numerically higher but not significant in the STEMI group (2.5% vs. 1.3%; p = 0.1). Conclusions: BVS implantation in an unrestricted cohort of STEMI patients is associated with a numerically higher rate of ScT compared to the non-STEMI group. Further studies exploring the potential clinical impact of a pre-specified BVS implantation strategy in this high-risk clinical setting are needed.

AB - Background: The bioresorbable vascular scaffold (BVS) technology may be an appealing option in ST-segment elevation myocardial infarction (STEMI) patients. However, the available evidence on its use in this challenging subset is limited. Methods: Registro Absorb Italiano (RAI) is a multicenter, prospective registry that aims to assess BVS performance through a 5-year follow-up of all consecutive patients who undergone at least 1 successful BVS implantation. As a part of it, a subgroup analysis in STEMI patients was performed and the outcomes of this cohort compared to the remaining population (defined as “non-STEMI”) are reported here. Results: Among the 1505 patients enrolled, 317 (21.1%) had STEMI on admission. Among those, 232 (73.2%) underwent primary percutaneous coronary intervention (PCI) within 12 h from symptom onset; 64 (20.2%) were late-comers (>12 h); 16 (5%) underwent PCI after successful thrombolysis while 5 (1.6%) underwent rescue-PCI. At a median follow-up time of 12 months (IQR 6–20 months) no differences were noticed between STEMI and “non-STEMI” groups in terms of device-oriented composite endpoint (4.1% vs. 5.6%; p = 0.3) and its singular components: ischemia-driven target lesion revascularization (3.2% vs. 3.6%; p = 0.7), target-vessel myocardial infarction (3.2% vs. 2.8%; p = 0.7) and cardiac death (0.6% vs. 0.6%; p = 0.9). The rate of definite/probable scaffold thrombosis (ScT) was numerically higher but not significant in the STEMI group (2.5% vs. 1.3%; p = 0.1). Conclusions: BVS implantation in an unrestricted cohort of STEMI patients is associated with a numerically higher rate of ScT compared to the non-STEMI group. Further studies exploring the potential clinical impact of a pre-specified BVS implantation strategy in this high-risk clinical setting are needed.

KW - Bioresorbable vascular scaffolds

KW - Percutaneous coronary interventions

KW - STEMI

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