Robust data on the outcome of BVS in the setting of ACS is still scarce.
Two investigator initiated, single-center, single-arm BVS registries have been pooled for the purpose of this study, namely the BVS Expand and BVS STEMI registries.
From September 2012–October 2014, 351 patients with a total of 428 lesions were enrolled. 255 (72.6%) were ACS patients and 99 (27.4%) presented with stable angina/silent ischemia. Mean number of scaffold/patient was 1.55 ± 0.91 in ACS group versus 1.91 ± 1.11 in non-ACS group (P = 0.11). Pre- and post-dilatation were performed less frequent in ACS patients, 75.7% and 41.3% versus 89.0% and 62.0% respectively (P = 0.05 and P = 0.001). Interestingly, post-procedural acute lumen gain and percentage diameter stenosis were superior in ACS patients, 1.62 ± 0.65 mm (versus 1.22 ± 0.49 mm, P < 0.001) and 15.51 ± 8.47% (versus 18.46 ± 9.54%, P = 0.04). Major adverse cardiac events (MACE) rate at 12 months was 5.5% in the ACS group (versus 5.3% in stable group, P = 0.90). One-year definite scaffold thrombosis rate was comparable: 2.0% for ACS population versus 2.1% for stable population (P = 0.94), however, early scaffold thromboses occurred only in ACS patients.
One-year clinical outcomes in ACS patients treated with BVS were similar to non-ACS patients. Acute angiographic outcomes were better in ACS than in non-ACS, yet the early thrombotic events require attention and further research.