Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Objectives: This study sought to evaluate the incidence and the mechanism of post-procedural cardiac biomarker (CB) rise following device implantation. Background: A fully bioresorbable absorb scaffold, compared with everolimus-eluting metallic stents (EES), might be associated with a higher incidence of periprocedural myocardial injury. Methods: Prospective nonrandomized comparative study enrolled 52 patients with stable myocardial ischemia with diffuse/ long LAD lesion for either an everolimus-eluting bioresorbable vascular (Absorb) scaffold (22 patients) or an everolimus-eluting metallic stent (30 patients), 3 types of CB (creatine kinase, creatine kinase-myocardial band, and troponin) were obtained before and after procedure. Per protocol, periprocedural myocardial infarction (PMI) was de{uFB01}ned as creatine kinase rise >2 the upper limit of normal with creatine kinase-myocardial band rise. Results: Incidence of side branch occlusion and any anatomic complications assessed by angiography was similar between the 2 treatment arms (side branch occlusion: Absorb: 4.5% vs. Xience: 6.7%, p 1; One PMI with acute instent thrombosis occurred in EES group. Dissection occurred in only 1 patient in BVS arm after stent implantation; this event was not associated with elevated cardiac biomarkers. One patient had PMI in BVS arm with no angiographic complications to explain it. Stent length and preprocedural TIMI flow grade were the independent determinants of per-protocol PMI (odds ratio (OR): 1.19, 95% con{uFB01}dence interval (CI): 1.033 to 1.376, P= 0.016; OR:0.049, 95% CI: 0.002 to 1.22, P=0.066; respectively). Conclusion: There were no difference in the incidence of CB and PMI between Absorb and EES. Stent length and preprocedural TIMI flow were the independent determinants for myocardial injury

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