Key result
SYNERGY stent linked to ~45% greater neointimal thickness vs PROMUS PREMIER alongside increased progenitor cell mobilization.
Why the study?
The vascular healing process after implantation of SYNERGY stents compared with PROMUS PREMIER stents in ACS patients was not well characterized.
Does the SYNERGY stent improve vascular healing compared to the PROMUS PREMIER stent in patients with acute coronary syndrome?
Observational (n=71)
No
Does the SYNERGY stent improve vascular healing compared to the PROMUS PREMIER stent in patients with acute coronary syndrome?
Absolute Event Rate: 0.16% vs 0.11%
p-value: p=0.0001
The SYNERGY stent demonstrated superior vascular healing and greater mobilization of progenitor cells compared to the PROMUS PREMIER stent in patients with acute coronary syndrome.
May support better vascular healing with SYNERGY in ACS; hypothesis-generating and requires RCT confirmation before practice change.
This study was aimed to compare the vascular healing process of a SYNERGY stent with that of a PROMUS PREMIER stent in patients with acute coronary syndrome (ACS). In 71 patients with ACS, undergoing coronary stent implantation using the SYNERGY stent (n = 52) or PROMUS PREMIER stent (n = 19), we measured circulating CD34+/CD133+/CD45null cells and CD34+/KDR+ cells and observed vascular healing at the stented sites using optical coherence tomography (OCT) and coronary angioscopy. On the day 7, circulating CD34+/CD133+/CD45null cells increased in SYNERGY group (P < 0.0001), while it did not change in PROMUS group. The CD34+/KDR+ cells also increased in SYNERGY group (P < 0.0001) but less significantly in the PROMUS group (P < 0.05). The OCT-based neointimal thickness (P < 0.0005) and neointimal coverage rate (P < 0.05) at 12 months were greater in SYNERGY group, compared with PROMUS group. The coronary angioscopy-based neointimal coverage grade at 12 months was also greater in SYNERGY group (P < 0.001). In overall patients, the change in CD34+/KDR+ cells on the day 7 correlated with the OCT-based neointimal thickness at 12 months (R = 0.288, P < 0.05). SYNERGY stent seems to have potential advantages over PROMUS PREMIER stent for ACS patients in terms of vascular healing process at the stented sites.
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Sakuma et al. (2021) conducted an observational in Acute coronary syndrome (n=71). SYNERGY stent vs. PROMUS PREMIER stent was evaluated on Mean neointimal thickness at 12 months by optical coherence tomography (mm) (p=0.0001). The SYNERGY stent induced greater mobilization of progenitor cells at day 7 and resulted in greater OCT-based neointimal thickness at 12 months (0.16 mm vs 0.11 mm, p=0.0001) compared to the PROMUS PREMIER stent in patients with acute coronary syndrome.
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