TY - JOUR
T1 - 1-Year outcomes with COMBO stents in small vessel coronary disease: Subgroup analysis from the COMBO collaboration
AU - Chandrasekhar, Jaya
AU - Zeebregts, Doreen
AU - Kalkman, Deborah N.
AU - Sartori, Samantha
AU - Roumeliotis, Anastasios
AU - Aquino, Melissa B.
AU - de Wilde, Puk
AU - de Winter, Vera C.
AU - Baber, Usman
AU - Woudstra, Pier
AU - Beijk, Marcel A.
AU - Hájek, Petr
AU - Atzev, Borislav
AU - Hudec, Martin
AU - Ong, Tiong Kiam
AU - Mates, Martin
AU - Borisov, Borislav
AU - Warda, Hazem M.
AU - den Heijer, Peter
AU - Wojcik, Jaroslaw
AU - Iniguez, Andres
AU - Lee, Michael
AU - Tijssen, Jan G.
AU - Koch, Karel T.
AU - Dangas, George D.
AU - MASCOT and REMEDEE Investigators (Appendix I)
AU - Colombo, Antonio
AU - Mehran, Roxana
AU - de Winter, Robbert J.
AU - MASCOT and REMEDEE Investigators
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Small vessel diameter is associated with higher risk of target lesion revascularization (TLR) after percutaneous coronary intervention (PCI). The COMBO sirolimus-eluting biodegradable-polymer stent has a proprietary anti-CD34 antibody layer to enhance homogeneous endothelialization, which may be advantageous in treating small vessels. Objective: We examined for differences in 1-year clinical outcomes after PCI by maximum implanted stent diameter from the COMBO collaboration. Methods: The COMBO collaboration (n = 3614) is a patient-level pooled dataset of patients undergoing PCI with COMBO stents in the MASCOT and REMEDEE multicenter registries. Stent diameter was available in 3590 (99.3%) patients. We compared patients receiving COMBO stents <3 mm versus ≥3 mm. The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel-myocardial infarction (TV-MI) or clinically driven TLR. Secondary outcomes included stent thrombosis (ST). Adjusted outcomes were assessed using Cox regression methods. Results: The study included 792 (22%) patients with small stents <3 mm and 2798 (78%) patients with large stents ≥3 mm. Small stent patients included more women with lower body mass index and higher prevalence of diabetes but similar prevalence of acute coronary syndrome. Risk of 1-year TLF was similar in small and large stent groups (4.4% vs. 3.8%, HR 1.12, 95% CI 0.74–1.72, p = 0.58). There were no differences in the rates of cardiac death (1.7% vs. 1.5%, p = 0.74), TV-MI (1.4% vs. 1.2%, p = 0.58) or TLR (2.7% vs. 2.1%, p = 0.31). Definite or probable ST occurred in 1.3% of the small stent and 0.7% of the large stent PCI patients, p = 0.14, HR 2.13, 95% CI 0.93–5.00, p = 0.07. Conclusions: One-year ischemic outcomes after COMBO PCI were similar irrespective of stent diameter in this all-comers international cohort.
AB - Background: Small vessel diameter is associated with higher risk of target lesion revascularization (TLR) after percutaneous coronary intervention (PCI). The COMBO sirolimus-eluting biodegradable-polymer stent has a proprietary anti-CD34 antibody layer to enhance homogeneous endothelialization, which may be advantageous in treating small vessels. Objective: We examined for differences in 1-year clinical outcomes after PCI by maximum implanted stent diameter from the COMBO collaboration. Methods: The COMBO collaboration (n = 3614) is a patient-level pooled dataset of patients undergoing PCI with COMBO stents in the MASCOT and REMEDEE multicenter registries. Stent diameter was available in 3590 (99.3%) patients. We compared patients receiving COMBO stents <3 mm versus ≥3 mm. The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel-myocardial infarction (TV-MI) or clinically driven TLR. Secondary outcomes included stent thrombosis (ST). Adjusted outcomes were assessed using Cox regression methods. Results: The study included 792 (22%) patients with small stents <3 mm and 2798 (78%) patients with large stents ≥3 mm. Small stent patients included more women with lower body mass index and higher prevalence of diabetes but similar prevalence of acute coronary syndrome. Risk of 1-year TLF was similar in small and large stent groups (4.4% vs. 3.8%, HR 1.12, 95% CI 0.74–1.72, p = 0.58). There were no differences in the rates of cardiac death (1.7% vs. 1.5%, p = 0.74), TV-MI (1.4% vs. 1.2%, p = 0.58) or TLR (2.7% vs. 2.1%, p = 0.31). Definite or probable ST occurred in 1.3% of the small stent and 0.7% of the large stent PCI patients, p = 0.14, HR 2.13, 95% CI 0.93–5.00, p = 0.07. Conclusions: One-year ischemic outcomes after COMBO PCI were similar irrespective of stent diameter in this all-comers international cohort.
KW - Anti-CD34
KW - Dual therapy stent
KW - Endothelial progenitor cell capture
KW - Percutaneous coronary intervention
KW - Small vessel coronary disease
UR - http://www.scopus.com/inward/record.url?scp=85086014171&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85086014171&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/32507695
U2 - https://doi.org/10.1016/j.carrev.2020.05.002
DO - https://doi.org/10.1016/j.carrev.2020.05.002
M3 - Article
C2 - 32507695
SN - 1553-8389
VL - 21
SP - 1542
EP - 1547
JO - Cardiovascular revascularization medicine
JF - Cardiovascular revascularization medicine
IS - 12
ER -