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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:327-34 - Vol. 71 Num.05 DOI: 10.1016/j.rec.2017.03.024

Angina and Ischemia at 2 Years With Bioresorbable Vascular Scaffolds and Metallic Drug-eluting Stents. ESTROFA Ischemia BVS-mDES Study

José M. de la Torre Hernández a,, José R. Rumoroso b, Soledad Ojeda c, Salvatore Brugaletta d, José D. Cascón e, Cristina Ruisánchez a, Joaquín Sánchez Gila f, Jessica Roa g, Helena Tizón h, Hipólito Gutiérrez i, Mariano Larman j, Tamara García Camarero a, Eduardo Pinar k, José F. Díaz g, Manuel Pan c, Miren Morillas Bueno b, José M. Oyonarte f, Luis Ruiz Guerrero a, Mireia Ble h, Ramón Rubio Patón e, Román Arnold i, Kattalin Echegaray j, Gonzalo de la Morena k, Manel Sabate d

a Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Cantabria, Spain
b Servicio de Cardiología, Hospital de Galdácano, Galdácano, Vizcaya, Spain
c Servicio de Cardiología, Hospital Reina Sofía, Córdoba, Spain
d Servicio de Cardiología, Hospital Clinic, Barcelona, Spain
e Servicio de Cardiología, Hospital de Cartagena, Cartagena, Murcia, Spain
f Servicio de Cardiología, Hospital Virgen de las Nieves, Granada, Spain
g Servicio de Cardiología, Hospital Juan Ramón Jiménez, Huelva, Spain
h Grupo de Investigación Biomédica en Enfermedades del Corazón, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Hospital del Mar, Barcelona, Spain
i Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain
j Servicio de Cardiología, Hospital Donostia, San Sebastián, Guipúzcoa, Spain
k Servicio de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain

Keywords

Bioresorbable scaffold. Drug-eluting stent. Angina. Ischemia. Stress echocardiography.

Abstract

Introduction and objectives

Bioresorbable vascular scaffolds (BVS) have the potential to restore vasomotion but the clinical implications are unknown. We sought to evaluate angina and ischemia in the long-term in patients treated with BVS and metallic drug-eluting stents (mDES).

Methods

Multicenter study including patients with 24 ± 6 months of uneventful follow-up, in which stress echocardiography was performed and functional status was assessed by the Seattle Angina Questionnaire (SAQ). The primary endpoint was a positive result in stress echocardiography.

Results

The study included 102 patients treated with BVS and 106 with mDES. There were no differences in the patients’ baseline characteristics. Recurrent angina was found in 18 patients (17.6%) in the BVS group vs 25 (23.5%) in the mDES group (P = .37), but SAQ results were significantly better in the BVS group (angina frequency 96.0 ± 8.0 vs 89.2 ± 29.7; P = .02). Stress echocardiography was positive in 11/92 (11.9%) of BVS patients vs 9/96 (9.4%) of mDES patients in the (P = .71) and angina was induced in 2/102 (1.9%) vs 7/106 (6.6%) (P = .18), respectively, but exercise performance was better in the BVS group even in those with positive tests (exercise duration 9.0 ± 2.0 minutes vs 7.7 ± 1.8 minutes; P = .02). A propensity score matching analysis yielded similar results.

Conclusions

The primary endpoint was similar in both groups. In addition, recurrent angina was similar in patients with BVS and mDES. The better functional status, assessed by means of SAQ and exercise performance, detected in patients receiving BVS should be confirmed in further studies.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved