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. 2021 Apr;35(2):309-320.
doi: 10.1007/s10557-020-07087-6. Epub 2021 Jan 30.

One-Year COMBO Stent Outcomes in Acute Coronary Syndrome: from the COMBO Collaboration

Jaya Chandrasekhar #  1   2 , Vera C de Winter #  2 , Deborah N Kalkman  2 , Samantha Sartori  1 , Rishi Chandiramani  1 , Melissa B Aquino  1 , Puk de Wilde  2 , Doreen Zeebregts  2 , Pier Woudstra  2 , Marcel A Beijk  2 , Petr Hájek  3 , Borislav Atzev  4 , Martin Hudec  5 , Tiong Kiam Ong  6 , Martin Mates  7 , Borislav Borisov  8 , Hazem M Warda  9 , Peter den Heijer  10 , Jaroslaw Wojcik  11 , Andres Iniguez  12 , Zdeněk Coufal  13 , Michael Lee  14 , Jan G Tijssen  2 , Karel T Koch  2 , Usman Baber  1 , George D Dangas  1 , Antonio Colombo  15 , Robbert J de Winter  2 , Roxana Mehran  16   17 ; MASCOT and REMEDEE investigators (Appendix I)
Affiliations

One-Year COMBO Stent Outcomes in Acute Coronary Syndrome: from the COMBO Collaboration

Jaya Chandrasekhar et al. Cardiovasc Drugs Ther. 2021 Apr.

Abstract

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.

Keywords: Acute coronary syndrome; Anti-CD34; Dual therapy stent; Endothelial progenitor cell capture; Percutaneous coronary intervention.

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References

    1. Giustino G, Baber U, Stefanini GG, Aquino M, Stone GW, Sartori S, et al. Impact of clinical presentation (stable angina pectoris vs unstable angina pectoris or non-ST-elevation myocardial infarction vs ST-elevation myocardial infarction) on long-term outcomes in women undergoing percutaneous coronary intervention with drug-eluting stents. Am J Cardiol. 2015;116(6):845–52. - DOI
    1. Izadnegahdar M, Mackay M, Lee MK, Sedlak TL, Gao M, Bairey Merz CN, et al. Sex and ethnic differences in outcomes of acute coronary syndrome and stable angina patients with obstructive coronary artery disease. Circ Cardiovasc Qual Outcomes. 2016;9(2 Suppl 1):S26–35. - DOI
    1. Ge Z, Baber U, Claessen BE, Chandrasekhar J, Chandiramani R, Li SX, et al. Associations between use of prasugrel vs clopidogrel and outcomes by type of acute coronary syndrome: an analysis from the PROMETHEUS registry. J Thromb Thrombolysis. 2019;48(1):42–51. - DOI
    1. Mehta SR, Wood DA, Storey RF, Mehran R, Bainey KR, Nguyen H, et al. Complete revascularization with multivessel PCI for myocardial infarction. N Engl J Med. 2019;381(15):1411–21. - DOI
    1. Saito S, Krucoff MW, Nakamura S, Mehran R, Maehara A, Al-Khalidi HR, et al. Japan-United States of America Harmonized Assessment by Randomized Multicentre Study of OrbusNEich’s Combo StEnt (Japan-USA HARMONEE) study: primary results of the pivotal registration study of combined endothelial progenitor cell capture and drug-eluting stent in patients with ischaemic coronary disease and non-ST-elevation acute coronary syndrome. Eur Heart J. 2018;39(26):2460–8. - DOI

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