Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis: final 7-year results of the COMPARE-ABSORB trial
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: The clinical outcomes of bioresorbable vascular scaffolds (BVS) compared with everolimus-eluting stents (EES) beyond 5-year follow-up are unknown. AIMS: This study aims to investigate clinical outcomes of BVS 7 years after implantation. METHODS: The COMPARE-ABSORB trial is an investigator-initiated, prospective randomised study. Patients at high risk of restenosis were randomly assigned to receive either a BVS or an EES. A dedicated implantation technique was recommended for BVS. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (TVMI), or clinically indicated target lesion revascularisation (CI-TLR). The primary and co-primary objectives were non-inferiority at 1 year and superiority of BVS at 7 years after a 3-year landmark analysis. RESULTS: Although enrolment was stopped at 1,670 patients (80% of the intended 2,100 patients; 848 patients receiving BVS and 822 EES) because of high thrombosis and TVMI rates in the BVS arm, non-inferiority for TLF at 1 year was met. At 7-year follow-up subsequent to a 3-year landmark analysis, the TLF rate of BVS was 6.7% versus 5.9% for EES (hazard ratio [HR] 1.14, 95% confidence interval [CI]: 0.76-1.77; p=0.53); therefore, superiority was not met. Cardiac death, TVMI, and device thrombosis rates did not differ between both groups; however, CI-TLR was significantly higher in the BVS arm (4.4% vs 2.2%; HR 1.97, 95% CI: 1.08-3.60; p=0.023). CONCLUSIONS: After complete resorption, no benefit was observed with BVS compared with EES at 7-year follow-up, despite the use of a dedicated implantation protocol for BVS. In fact, after 3 years, more target lesion revascularisations occurred with BVS than with EES.
Source: EuroIntervention
Authors: Pieter C. Smits, Adrian Włodarczak, Bernard Chevalier, Nick E.J. West, Tommaso Gori, Mohamed Abdel-Wahab, Emanuele Barbato, Giovanni Esposito, Giuseppe Tarantini, Viktor Kocka, Stephan Achenbach, Dariusz Dudek, Javier Escaned, Jan G.P. Tijssen, Tessa A.M. Rademaker-Havinga, Patrick Serruys, Marie-Claude Morice, Yoshinobu Onuma, Robert-Jan van Geuns, on behalf of the COMPARE-ABSORB trial investigators
Institutions: Cardiovascular European Research Center, Maasstad Ziekenhuis, Institut Cardiovasculaire Paris Sud, Wrocław University of Science and Technology, Hôpital Privé Jacques Cartier, Royal Papworth Hospital, Papworth Hospital NHS Foundation Trust, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Leipzig Heart Institute, Segeberger Kliniken, Leipzig University, Azienda Ospedaliera Sant'Andrea, Sapienza University of Rome, University of Naples Federico II, University of Padua, Charles University, University Hospital Kralovske Vinohrady, Friedrich-Alexander-Universität Erlangen-Nürnberg, Jagiellonian University, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Amsterdam University Medical Centers, Cardialysis (Netherlands), Ollscoil na Gaillimhe – University of Galway, Radboud University Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7128441540