1-year results after PCI with the COMBO stent in all-comers in Asia versus Europe: Geographical insights from the COMBO collaboration.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 05 2020
Historique:
received: 30 10 2019
revised: 03 01 2020
accepted: 20 01 2020
pubmed: 1 3 2020
medline: 15 5 2021
entrez: 1 3 2020
Statut: ppublish

Résumé

The COMBO drug-eluting stent combines sirolimus-elution from a biodegradable polymer with an anti-CD34+ antibody coating for early endothelialization. We investigated for geographical differences in outcomes after percutaneous coronary intervention (PCI) with the COMBO stent among Asians and Europeans. The COMBO Collaboration is a pooled patient-level analysis of the MASCOT and REMEDEE registries of all-comers undergoing attempted COMBO stent PCI. The primary outcome was 1-year target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization (TLR). This study included 604 Asians (17.9%) and 2775 Europeans (82.1%). Asians were younger and included fewer females, with a higher prevalence of diabetes mellitus but lower prevalence of other comorbidities than Europeans. Asians had a higher prevalence of ACC/AHA C type lesions and received longer stent lengths. More Asians than Europeans were discharged on clopidogrel (86.5% vs 62.8%) rather than potent P2Y In the COMBO collaboration, although 1-year TLF was similar regardless of geography, Asians experienced higher rates of cardiac death and lower TLR than Europeans, while incidence of TV-MI and ST was similar in both regions. Adjusted differences did not reach statistical significance. CLINICALTRIAL. NCT01874002 (REMEDEE Registry), NCT02183454 (MASCOT registry).

Sections du résumé

BACKGROUND
The COMBO drug-eluting stent combines sirolimus-elution from a biodegradable polymer with an anti-CD34+ antibody coating for early endothelialization.
OBJECTIVE
We investigated for geographical differences in outcomes after percutaneous coronary intervention (PCI) with the COMBO stent among Asians and Europeans.
METHODS
The COMBO Collaboration is a pooled patient-level analysis of the MASCOT and REMEDEE registries of all-comers undergoing attempted COMBO stent PCI. The primary outcome was 1-year target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization (TLR).
RESULTS
This study included 604 Asians (17.9%) and 2775 Europeans (82.1%). Asians were younger and included fewer females, with a higher prevalence of diabetes mellitus but lower prevalence of other comorbidities than Europeans. Asians had a higher prevalence of ACC/AHA C type lesions and received longer stent lengths. More Asians than Europeans were discharged on clopidogrel (86.5% vs 62.8%) rather than potent P2Y
CONCLUSIONS
In the COMBO collaboration, although 1-year TLF was similar regardless of geography, Asians experienced higher rates of cardiac death and lower TLR than Europeans, while incidence of TV-MI and ST was similar in both regions. Adjusted differences did not reach statistical significance. CLINICALTRIAL.
GOV IDENTIFIER-NUMBERS
NCT01874002 (REMEDEE Registry), NCT02183454 (MASCOT registry).

Identifiants

pubmed: 32111358
pii: S0167-5273(19)35338-0
doi: 10.1016/j.ijcard.2020.01.045
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02183454']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

17-23

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest 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. Dr. Kala has served as a consultant for Boston Scientific; has received research support from AstraZeneca, Novartis, Zoll; has served on advisory board for Astra Zeneca, Bayer, Medtronic and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Jaya Chandrasekhar (J)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America; Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Deborah N Kalkman (DN)

Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Melissa B Aquino (MB)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America.

Samantha Sartori (S)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America.

Petr Hájek (P)

Motol University Hospital, Prague, Czech Republic.

Borislav Atzev (B)

University Hospital St. Ekaterina, Sofia, Bulgaria.

Martin Hudec (M)

SUSCCH, a.s. Banska Bystrica, Slovakia.

Tiong Kiam Ong (TK)

Sarawak Heart Centre, Sarawak, Malaysia.

Martin Mates (M)

Nemocnice na Homolce - Kardiologie, Prague, Czech Republic.

Borislav Borisov (B)

MBAL St. Ivan Rilski, Bulgaria.

Hazem M Warda (HM)

Alhyatt Cardiovascular Center and Tanta University Hospital, Alexandria, Egypt.

Peter den Heijer (P)

Breda Amphia, Breda, the Netherlands.

Jaroslaw Wojcik (J)

Hospital of Invasive Cardiology IKARDIA, Lublin, Nałęczów, Poland.

Andrés Iñiguez (A)

Hospital Álvaro Cunqueiro, Vigo, Spain.

Zdeněk Coufal (Z)

T. Bata Regional Hospital Zlin, Zlin, Czech Republic.

Ahmed Khashaba (A)

Al-Dorrah Heart Center, Cairo, Egypt.

Alexandr Schee (A)

Karlovarská krajská nemocnice a.s., Karlovy Vary, Czech Republic.

Muhammad Munawar (M)

Bina Waluya Hospital, Jakarta, Indonesia.

Robert T Gerber (RT)

Conquest Hospital, East Sussex, UK.

Bryan P Yan (BP)

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.

Paula Tejedor (P)

Hospital Universitario Burgos, Burgos, Spain.

Petr Kala (P)

University Hospital Brno, Brno, Czech Republic.

Houng Bang Liew (HB)

Hospital Queen Elizabeth II, Sabah, Malaysia.

Michael Lee (M)

Queen Elizabeth Hospital, Kowloon, Hong Kong.

Usman Baber (U)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America.

Birgit Vogel (B)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America.

George D Dangas (GD)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America.

Antonio Colombo (A)

San Raffaele Hospital, Milan, Italy.

Robbert J de Winter (RJ)

Amsterdam UMC, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Roxana Mehran (R)

Icahn School of Medicine at Mount Sinai Hospital, New York, United States of America. Electronic address: roxana.mehran@mountsinai.org.

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