The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Bioresorbable vascular scaffold versus Xience metallic stents: outcomes in the AIDA trial stratified by SYNTAX score

EuroIntervention 2019; just accepted article published in May 2019. DOI: 10.4244/EIJ-D-18-00884

1. Amsterdam UMC - University of Amsterdam, Amsterdam - AMC Heart Center, The Netherlands, NETHERLANDS; 2. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 3. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands; 4. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 5. Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands; 6. Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands; 7. Department of Cardiology, Tergooi Hospital, Blaricum, The Netherlands; 8. Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands; 9. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 10. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 11. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 12. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 13. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 14. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 15. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 16. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 17. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 18. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands; 19. Amsterdam UMC– University of Amsterdam, Amsterdam – AMC Heart Center, The Netherlands
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Aims: We evaluated the impact of the complexity of coronary disease assessed by SYNTAX score (SXscore) on the clinical outcomes in the AIDA trial.

Methods and results: In the AIDA trial, we compared Absorb versus Xience in routine clinical practice. Clinical outcomes were stratified by SXscore tertiles: SXlow (SXscore≤8), SXmid (SXscore >8 and ≤15) and SXhigh (>15). SXscore was available in 1661 of the 1845 (90%) patients. Event rate of TVF was numerically lower in Absorb compared to Xience (3.7% versus 5.6%; p=0.257) in the Sxlow tertile, numerically higher in Absorb in in the Sxmid tertile (11.4% versus 9.3%, p=0.421) and similar in the Sxhigh tertile (15.5% versus. 15.6%; p=0.960) . The rates of definite/probable device thrombosis in Absorb versus Xience were significantly higher in the Sxmid tertile (3.3% versus 0.8%, p=0.043) and in the SXhigh tertile (3.7% versus 0.8%, p=0.006) Patients treated with Absorb and a SXscore>8 had numerically, but non significantly, higher rates of myocardial revascularization and revascularization rates when compared to Xience.

Conclusions: We found no significantly different rates of TVF between Absorb and Xience patients. Absorb treated patients in the Sxmid and SXhigh tertile, however, had an increased risk of device thrombosis when compared to Xience treated patients. The rates of device thrombosis in the SXlow tertile, while still higher for Absorb, but are more acceptable than in SXmid and SXhigh score tertiles.

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