What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Acute coronary syndrome (n=622). Intervention: Magmaris bioresorbable magnesium scaffold vs. Drug-eluting stents (DES). Primary outcome: Target-lesion failure (TLF) at 1 year (OR 1.53, 95% CI 0.79-2.97, p=0.21).

May 20, 2026Frontiers in Cardiovascular Medicine0 citationsOpen Access

Magmaris bioresorbable magnesium scaffold in acute coronary syndromes: a systematic review and meta-analysis

SWSimon Wölbert PEPablo F. F. Escrihuela-Branz SKStephanie Gladys Kühne

Key Result

In patients with acute coronary syndrome, the Magmaris bioresorbable magnesium scaffold showed no statistically significant difference in 1-year target-lesion failure compared to drug-eluting stents (OR 1.53).

Study Design

Type

Meta-Analysis (n=622)

Structured PICO

Does the Magmaris bioresorbable magnesium scaffold reduce target-lesion failure compared to drug-eluting stents in patients with acute coronary syndromes?

Population

1,391 patients with acute coronary syndrome (ACS) across 12 studies (4 studies with n=622 for pairwise comparison vs DES).

Intervention

Magmaris bioresorbable magnesium scaffold

Comparator

Drug-eluting stents (DES)

Outcome

Target-lesion failure (TLF) defined as composite of cardiac death (CD), target-vessel myocardial infarction (TV-MI) and target-lesion revascularization (TLR) at one yearcomposite

In patients with acute coronary syndromes, the Magmaris bioresorbable scaffold showed no significant difference in 1-year target-lesion failure compared to DES, but was associated with significantly higher rates of target-lesion revascularization.

Main Result

Effect estimate: OR 1.53 (95% CI 0.79-2.97)

Absolute Event Rate: 7.5% vs 5.3%

p-value: p=0.21

Limitations

Study-level meta-analysis based on aggregated published data rather than individual patient data
Heterogeneity in endpoint definitions, implantation protocols, and follow-up durations
Small number of comparative studies, reducing statistical power
Pooling randomized with non-randomized comparative designs may have introduced residual confounding
Comparator DES were limited to Orsiro, Xience, and Ultimaster
Procedure-related factors were inconsistently reported across studies
Most included studies were conducted at medium- to high-volume PCI centers

Abstract

Background Bioresorbable scaffolds aim to mitigate long-term complications of drug-eluting stents (DES). The bioresorbable magnesium scaffold Magmaris is an alternative, but its role in acute coronary syndrome (ACS) remains insufficiently studied. Therefore, we aimed to evaluate safety and efficacy of Magmaris in ACS and compare outcomes with DES. Methods We systematically searched PubMed, Embase and Cochrane Central Register of Controlled Trials for randomized and observational studies reporting outcomes of Magmaris in ACS. Primary outcome was target-lesion failure (TLF) defined as composite of cardiac death (CD), target-vessel myocardial infarction (TV-MI) and target-lesion revascularization (TLR) at one year. Secondary outcomes included scaffold/stent thrombosis (ST) and procedural success. Single-arm pooled event rates and pairwise comparisons were estimated using generalized linear mixed-effects models (GLMM). Results We included four studies ( n = 622 patients; 322 Magmaris, 300 DES) for pairwise analysis. At one year, no statistically significant difference in TLF was observed between Magmaris and DES (7.5% vs. 5.3%, OR 1.53, 95% CI 0.79–2.97; p = 0.21; I 2 = 54.7%), although confidence intervals were wide. TLR was significantly higher with Magmaris (6.8% vs. 3.0%, OR 2.63, 95% CI 1.17–5.90; p = 0.019; I 2 = 10.7%), while TV-MI, CD and ST did not differ significantly between groups. Twelve studies ( n = 1,391 patients) contributed single-arm analyses showing pooled 1-year incidence of TLF 4.97%, TLR 4.16% and ST 0.83%. Procedural success was 98.49% (95% CI 97.21–99.18; I 2 = 35.4%). Conclusion In ACS, Magmaris was associated with low observed ST rates, nevertheless, comparative safety and efficacy vs. DES remain uncertain due to limited and heterogeneous evidence. Higher TLR rates with Magmaris suggest that further technical improvements in next-generation magnesium scaffolds are needed before this strategy can be considered a robust alternative in ACS.

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