Impact of the bioresorbable vascular scaffold surface area on on-treatment platelet reactivity

Abstract

While promising data with the novel bioresorbable vascular scaffold (BVS) are accumulating, signals of scaffold thrombosis (ST) were noted in recent reports. We aimed to assess the relationship between the total surface area (TSA) of implanted everolimus-eluting BVSs and the on-treatment adenosine diphosphate (ADP)-induced platelet reactivity in patients undergoing percutaneous coronary intervention (PCI). 202 consecutive patients undergoing BVS implantation and platelet function testing were included. For investigating the impact of the scaffold surface on platelet reactivity, patients were stratified into two groups regarding the median BVS TSA. The on-treatment ADP-induced platelet reactivity was determined with the Multiplate analyzer and 30-day follow-up was available in 98% of patients. ADP-induced platelet aggregation values (median, [IQR]) did not differ between the two study groups (12.0 [9.0–19.0] U for patients with TSA > 1.39 cm² and 13.0 [9.0–19.5] U for patients with TSA ≤ 1.39 cm²; p = 0.69). No correlation was observed between the BVS TSA and levels of platelet reactivity (Spearman rank correlation = −0.10, p = 0.16). At 30 days after PCI, two early STs (1%) were documented. Thus, in patients on a dual antiplatelet treatment regimen following BVS implantation, the extent of blood-to-BVS contact surface does not negatively affect levels of on-treatment platelet reactivity.

Keywords:

• Bioresorbable vascular scaffold
• platelet activation
• platelet function testing
• scaffold thrombosis

Declaration of interest

JM received modest lecture fees from Abbott Vascular and Terumo. DS received speaker fees from Daiichi Sankyo and Roche and fees for advisory board activities from Verum Diagnostica and Eli Lilly. All other authors report no declarations of interest.