TY - JOUR
T1 - One-Year COMBO Stent Outcomes in Acute Coronary Syndrome: from the COMBO Collaboration
AU - Chandrasekhar, Jaya
AU - de Winter, Vera C.
AU - Kalkman, Deborah N.
AU - Sartori, Samantha
AU - Chandiramani, Rishi
AU - Aquino, Melissa B.
AU - de Wilde, Puk
AU - Zeebregts, Doreen
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 - Coufal, Zdeněk
AU - Lee, Michael
AU - Tijssen, Jan G.
AU - Koch, Karel T.
AU - Baber, Usman
AU - Dangas, George D.
AU - Colombo, Antonio
AU - de Winter, Robbert J.
AU - On behalf of the MASCOT and REMEDEE investigators (Appendix I)
AU - Mehran, Roxana
N1 - Funding Information: The Academic Medical Center received an unrestricted research grant from OrbusNeich Medical BV (Hoevelaken, The Netherlands). OrbusNeich Medical (Ft.Lauderdale, Florida, USA) is the sponsor of the MASCOT registry. Funding Information: Dr. Mehran has received institutional research grant support from Eli Lilly/Daiichi-Sankyo Inc., AstraZeneca, The Medicines Company, Bristol-Myers Squibb, OrbusNeich, Beth Israel Deaconess, and Bayer; has served as a consultant for Boston Scientific, Cardiovascular Systems Inc., Medscape, and Shanghai BraccoSine Pharmaceutical; has received institutional advisory board funding from Bristol-Myers Squibb; has received institutional funding from Claret Medical; owns equity in Claret Medical and Elixir Medical; has served on the executive committee for Janssen Pharmaceuticals and Osprey Medical; has served on the data safety monitoring board for Watermark Research Partners; and has a spouse who has served as a consultant for Abiomed and the Medicines Company. All the other authors have no relevant disclosures. Publisher Copyright: © 2021, Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: The COMBO biodegradable polymer sirolimus-eluting stent includes endothelial progenitor cell capture (EPC) technology for rapid endothelialization, which may offer advantage in acute coronary syndromes (ACS). We sought to analyze the performance of the COMBO stent by ACS status and ACS subtype. Methods: The COMBO collaboration (n = 3614) is a patient-level pooled dataset from the MASCOT and REMEDEE registries. We evaluated outcomes by ACS status, and ACS subtype in patients with ST segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) versus unstable angina (UA). The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Secondary outcomes included stent thrombosis (ST). Results: We compared 1965 (54%) ACS and 1649 (46.0%) non-ACS patients. ACS presentations included 40% (n = 789) STEMI, 31% (n = 600) NSTEMI, and 29% (n = 576) UA patients. Risk of 1-year TLF was greater in ACS patients (4.5% vs. 3.3%, HR 1.51 95% CI 1.01–2.25, p = 0.045) without significant differences in definite/probable ST (1.1% vs 0.5%, HR 2.40, 95% CI 0.91–6.31, p = 0.08). One-year TLF was similar in STEMI, NSTEMI, and UA (4.8% vs 4.8% vs. 3.7%, p = 0.60), but definite/probable ST was higher in STEMI patients (1.9% vs 0.5% vs 0.7%, p = 0.03). Adjusted outcomes were not different in MI versus UA patients. Conclusions: Despite the novel EPC capture technology, COMBO stent PCI was associated with somewhat greater risk of 1-year TLF in ACS than in non-ACS patients, without significant differences in stent thrombosis. No differences were observed in 1-year TLF among ACS subtypes.
AB - Purpose: The COMBO biodegradable polymer sirolimus-eluting stent includes endothelial progenitor cell capture (EPC) technology for rapid endothelialization, which may offer advantage in acute coronary syndromes (ACS). We sought to analyze the performance of the COMBO stent by ACS status and ACS subtype. Methods: The COMBO collaboration (n = 3614) is a patient-level pooled dataset from the MASCOT and REMEDEE registries. We evaluated outcomes by ACS status, and ACS subtype in patients with ST segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) versus unstable angina (UA). The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Secondary outcomes included stent thrombosis (ST). Results: We compared 1965 (54%) ACS and 1649 (46.0%) non-ACS patients. ACS presentations included 40% (n = 789) STEMI, 31% (n = 600) NSTEMI, and 29% (n = 576) UA patients. Risk of 1-year TLF was greater in ACS patients (4.5% vs. 3.3%, HR 1.51 95% CI 1.01–2.25, p = 0.045) without significant differences in definite/probable ST (1.1% vs 0.5%, HR 2.40, 95% CI 0.91–6.31, p = 0.08). One-year TLF was similar in STEMI, NSTEMI, and UA (4.8% vs 4.8% vs. 3.7%, p = 0.60), but definite/probable ST was higher in STEMI patients (1.9% vs 0.5% vs 0.7%, p = 0.03). Adjusted outcomes were not different in MI versus UA patients. Conclusions: Despite the novel EPC capture technology, COMBO stent PCI was associated with somewhat greater risk of 1-year TLF in ACS than in non-ACS patients, without significant differences in stent thrombosis. No differences were observed in 1-year TLF among ACS subtypes.
KW - Acute coronary syndrome
KW - Anti-CD34
KW - Dual therapy stent
KW - Endothelial progenitor cell capture
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85100563887&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10557-020-07087-6
DO - https://doi.org/10.1007/s10557-020-07087-6
M3 - Article
C2 - 33515411
SN - 0920-3206
VL - 35
SP - 309
EP - 320
JO - Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy
JF - Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy
IS - 2
ER -