Therapeutic Efficacy Analysis Of NeoVas Bioresorbable Stent In The Treatment Of Coronary Artery Lesions In Situ

Objective:To compare the safety and efficacy of NeoVas bioresorbable vascular scaffold with drug-eluting stents and drug-coated balloons after 1 year of implantation,and to investigate the risk factors affecting the prognosis of patients implanted with NeoVas BVS.Methods:(1)Forty-one patients implanted with NeoVas BVS stents were enrolled consecutively as the experimental group,and 40 patients implanted with drug-eluting stents and 40 patients implanted with drug-coated balloons were selected as the control group,and clinical data were collected for comparison.(2)Baseline clinical data and coronary angiography data were recorded,and the patients were followed up with clinical endpoints at 12 months and coronary angiography at 12 months.(3)Within-group differences in measures were analyzed by ANOVA or Kruskal-Wallis H test,and within-group differences in counts were analyzed by chi-square test or Fisher’s exact probability method.The cumulative survival curves of MACE were plotted using the Kaplan-Meier method,and the differences between the cumulative MACE survival curves of patients in the BVS,DES and DEB groups were examined by the Log-rank method.Risk factors affecting the prognosis of NeoVas BVS implantation were investigated using LASSOLogistic regression analysis of the screened variables.Results:(1)There were no significant differences in lesion data between the three groups preoperatively or intraoperatively,and differences in postoperative minimum lumen diameter,postoperative minimum diameter stenosis,and acute lumen benefit existed between the three groups(P < 0.05),further two-by-two comparison revealed that the differences between the BVS and DES groups were not statistically significant,but all were superior to the DEB group.(2)The results of 401.9±159.7 days of imaging follow-up showed no statistically significant differences between the three groups in the minimum lumen diameter at follow-up,the minimum lumen stenosis at follow-up,and late lumen loss(P > 0.05).(3)The median 489(374,561)days of follow-up for MACE events showed no significant difference in the incidence of MACE among the three groups(P > 0.05).(4)Lasso-logistic regression analysis showed that combined diabetes(OR=29.612,P=0.002,95% CI: 3.450～254.16)and LDL-C(OR=6.674,P=0.015,95% CI: 1.337～30.785)were independent risk factors for the occurrence of MACE in patients in the BVS group factors,and late lumen loss was higher in the BVS group with combined diabetes and high levels of LDL-C,and the difference was statistically significant(P < 0.05).Conclusions:(1)BVS is a safe and effective treatment in coronary artery lesions.(2)In the immediate postoperative efficacy observation,the BVS and DES groups were superior to the DEB group,however,the difference in the incidence of clinical events among the three groups was not statistically significant.(3)In the postoperative imaging follow-up,the BVS group had comparable therapeutic efficacy compared with DES and DEB.(4)Combined diabetes mellitus and elevated LDL-C were independent risk factors for the occurrence of MACE in patients with BVS implantation.(5)Late lumen loss was increased in the BVS group in patients with combined diabetes or LDL-C levels ≥3.12mmol/L.