Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry)

• Published in: International journal of cardiology 2018-05, Vol.258, p.50-54
• Main Authors: Moscarella, Elisabetta, Ielasi, Alfonso, Varricchio, Attilio, De Angelis, Maria Carmen, Loi, Bruno, Tarantini, Giuseppe, Calabrò, Paolo, Cortese, Bernardo, Mazzarotto, Pietro, Gabrielli, Gabriele, Pisano, Francesco, Facchin, Michela, Misuraca, Leonardo, Lucci, Valerio, Gistri, Roberto, Tumminello, Gabriele, Moretti, Luciano, Colombo, Alessandro, Durante, Alessandro, Fineschi, Massimo, Piraino, Davide, Ferrario, Maurizio, Coscarelli, Sebastian, Nicolino, Annamaria, Tespili, Maurizio, Corrado, Donatella, Steffenino, Giuseppe
• Format: Article
• Language: English
• Subjects: Bioresorbable vascular scaffolds; Percutaneous coronary interventions; STEMI
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2018.01.135

The bioresorbable vascular scaffold (BVS) technology may be an appealing option in ST-segment elevation myocardial infarction (STEMI) patients. However, the available evidence on its use in this challenging subset is limited. Registro Absorb Italiano (RAI) is a multicenter, prospective registry that aims to assess BVS performance through a 5-year follow-up of all consecutive patients who undergone at least 1 successful BVS implantation. As a part of it, a subgroup analysis in STEMI patients was performed and the outcomes of this cohort compared to the remaining population (defined as “non-STEMI”) are reported here. Among the 1505 patients enrolled, 317 (21.1%) had STEMI on admission. Among those, 232 (73.2%) underwent primary percutaneous coronary intervention (PCI) within 12 h from symptom onset; 64 (20.2%) were late-comers (>12 h); 16 (5%) underwent PCI after successful thrombolysis while 5 (1.6%) underwent rescue-PCI. At a median follow-up time of 12 months (IQR 6–20 months) no differences were noticed between STEMI and “non-STEMI” groups in terms of device-oriented composite endpoint (4.1% vs. 5.6%; p = 0.3) and its singular components: ischemia-driven target lesion revascularization (3.2% vs. 3.6%; p = 0.7), target-vessel myocardial infarction (3.2% vs. 2.8%; p = 0.7) and cardiac death (0.6% vs. 0.6%; p = 0.9). The rate of definite/probable scaffold thrombosis (ScT) was numerically higher but not significant in the STEMI group (2.5% vs. 1.3%; p = 0.1). BVS implantation in an unrestricted cohort of STEMI patients is associated with a numerically higher rate of ScT compared to the non-STEMI group. Further studies exploring the potential clinical impact of a pre-specified BVS implantation strategy in this high-risk clinical setting are needed. •Bioresorbable vascular scaffolds may be an appealing option in STEMI patients.•The RAI registry included 1505 patients with at least 1 successful BVS implantation.•A subgroup analysis in STEMI patients included in the RAI registry was performed.•BVS in STEMI is associated with a higher rate of thrombosis compared to non-STEMI.