Original title: 1-Year Clinical Outcomes of Diabetic Patients Treated With Everolimus-Eluting Bioresorbable Vascular Scaffolds A Pooled Analysis of the ABSORB and the SPIRIT Trials. Reference: Muramatsu T et al. JACC CardiovascInterv. 2014 May;7(5):482-93.
This study included ABSORB, ABSORB Extend and SPIRIT patients. A total of 136 diabetic patients and 415 non diabetic receiving everolimus-eluting bioresorbable scaffolds (Absorb) and 882 diabetic patients receiving everolimus-eluting metal stents (Xience) in the SPIRIT studies.
Primary end point was a composite of cardiac death, target vessel myocardial infarction and target lesion revascularization at 1 year follow up. Propensity score matching was applied to adjust for differences in baseline characteristics.
Primary end point incidence in patients receiving the Absorb scaffold did not differ significantly between diabetic and non-diabetic patients (3.7% vs 5.1%; p=0.64). Neither were differences significant when comparing Absorb vs. Xience outcomes in diabetic patients (3.9% vs 6.4% respectively; p=0.38).
Definitive or probable thrombosis incidence resulted in 0.7% both for diabetic and non-diabetic receiving Absorb and 1.7% for diabetics receiving XIENCE in this matched population, also outcomes of no statistical significance.
Conclusion
This analysis showed that everolimus-eluting bioresorbable scaffold outcomes are similar in diabetic and non-diabetic patients treated with the same device, and are also similar to everolimus eluting metal stent outcomes in diabetic patients.
Editorial Comment
Even though patients were diabetic, the anatomical complexity of all patients included in the referred studies was low. It should also be noted there are methodological limitations to this study and therefore its results should be considered as hypothesis generators. Finally, follow up beyond bioresorbable scaffold actual disappearance is mandatory.
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