Impact of Strut Width in Periprocedural Myocardial Infarction: A Propensity-Matched Comparison Between Bioresorbable Scaffolds and the First-Generation Sirolimus-Eluting Stent

Hiroyoshi Kawamoto, Vasileios F. Panoulas, Katsumasa Sato, Tadashi Miyazaki, Toru Naganuma, Alessandro Sticchi, Filippo Figini, Azeem Latib, Alaide Chieffo, Mauro Carlino, Matteo Montorfano, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract Objectives This study aimed to assess the clinical impact of strut width (evaluated by abluminal strut surface area [ASSA]) on periprocedural myocardial infarction (PMI) and clinical outcomes in patients treated with bioresorbable scaffolds (BRS) versus first-generation sirolimus-eluting stents (SES). Background To date, there are no reports on the impact of ASSA on PMI and clinical outcomes. Methods We compared the impact of ASSA on outcomes and PMI in propensity-matched patients treated with BRS and SES. The primary outcome was the incidence of major adverse cardiac events (MACE), defined as the combination of all-cause mortality, follow-up myocardial infarction, and target vessel revascularization, at 30-days and 1-year follow-ups. The secondary endpoint was the incidence of PMI. Results After propensity-matched analysis, 499 patients (147 BRS patients vs. 352 SES patients) were evaluated. Mean ASSA was higher in patients treated with BRS versus SES (BRS: 132.3 ± 76.7 mm2 vs. SES: 67.6 ± 48.4 mm2, p <0.001). MACE was not significantly different between groups (30-days MACE: BRS: 0% vs. SES: 1.4%, p = 0.16, and 1-year MACE: BRS: 15.7% vs. SES: 11.4%, p = 0.67). The incidence of PMI was significantly higher in the BRS group (BRS: 13.1% vs. SES: 7.5%, p = 0.05). Multivariable analyses indicated that treatment of left anterior descending artery and ASSA were independent predictors of PMI. Conclusions BRS implantation, compared with SES implantation, was associated with a higher incidence of PMI. MACE at 30 days and 1 year were not significantly different. Left anterior descending artery percutaneous coronary intervention and ASSA were independent predictors of PMI.

Original languageEnglish
Article number1991
Pages (from-to)900-909
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume8
Issue number7
DOIs
Publication statusPublished - Jun 1 2015

Keywords

  • bioresorbable scaffold
  • first generation
  • periprocedural myocardial infarction
  • sirolimus-eluting stent
  • strut width

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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