Journal Club


Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease





In patients with coronary artery disease who receive metallic drug-eluting coronary
stents, adverse events such as late target-lesion failure may be related in part
to the persistent presence of the metallic stent frame in the coronary-vessel wall.
Bioresorbable vascular scaffolds have been developed to attempt to improve longterm


In this large, multicenter, randomized trial, 2008 patients with stable or unstable
angina were randomly assigned in a 2:1 ratio to receive an everolimus-eluting
bioresorbable vascular (Absorb) scaffold (1322 patients) or an everolimus-eluting
cobalt–chromium (Xience) stent (686 patients). The primary end point, which was
tested for both noninferiority (margin, 4.5 percentage points for the risk difference)
and superiority, was target-lesion failure (cardiac death, target-vessel myocardial
infarction, or ischemia-driven target-lesion revascularization) at 1 year.


Target-lesion failure at 1 year occurred in 7.8% of patients in the Absorb group and
in 6.1% of patients in the Xience group (difference, 1.7 percentage points; 95%
confidence interval, −0.5 to 3.9; P = 0.007 for noninferiority and P = 0.16 for superiority).
There was no significant difference between the Absorb group and the
Xience group in rates of cardiac death (0.6% and 0.1%, respectively; P = 0.29), targetvessel
myocardial infarction (6.0% and 4.6%, respectively; P = 0.18), or ischemiadriven
target-lesion revascularization (3.0% and 2.5%, respectively; P = 0.50). Device
thrombosis within 1 year occurred in 1.5% of patients in the Absorb group and in
0.7% of patients in the Xience group (P = 0.13).


In this large-scale, randomized trial, treatment of noncomplex obstructive coronary
artery disease with an everolimus-eluting bioresorbable vascular scaffold, as compared
with an everolimus-eluting cobalt–chromium stent, was within the prespecified
margin for noninferiority with respect to target-lesion failure at 1 year.

Supplementary Material

ABSORB Japan trial
ABSORB China slides

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