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

Coronary interventions - Mini focus on bioresorbable scaffolds

Outcomes of bioresorbable vascular scaffolds versus everolimus-eluting stents by coronary complexity: a sub-analysis of the AIDA trial

EuroIntervention 2020;16:e904-e912. DOI: 10.4244/EIJ-D-18-00884

1. Amsterdam UMC and AMC Heart Center, University of Amsterdam, Amsterdam, the Netherlands; 2. Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; 3. Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, the Netherlands; 4. Department of Cardiology, Tergooi Hospital, Blaricum, the Netherlands; 5. Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands

Aims: We aimed to evaluate the impact of the complexity of coronary disease as assessed by the 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). The SXscore was available in 1,661 of the 1,845 (90%) patients. The 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 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).

Conclusions: We found no significantly different rates of TVF between Absorb and XIENCE patients. Absorb-treated patients in the SXmid and SXhigh tertiles 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, are more acceptable than in the SXmid and SXhigh score tertiles.

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