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.

Department of Cardiology Alhyatt Cardiovascular Center Alexandria and Tanta University Hospital Tanta Egypt

Department of Cardiology Breda Amphia Breda Netherlands

Department of Cardiology Hospital Álvaro Cunqueiro Vigo Spain

Department of Cardiology MBAL St Ivan Rilski Dupnitsa Bulgaria

Department of Cardiology Motol University Hospital Prague Czech Republic

Department of Cardiology Nemocnice na Homolce Kardiologie Prague Czech Republic

Department of Cardiology Queen Elizabeth Hospital Kowloon Hong Kong

Department of Cardiology San Raffaele Hospital Milan Italy

Department of Cardiology Sarawak Heart Centre Kota Samarahan Sarawak Malaysia

Department of Cardiology SUSCCH a s Banska Bystrica Banska Bystrica Slovakia

Department of Cardiology T Bata Regional Hospital Zlin Zlin Czech Republic

Department of Cardiology University Hospital St Ekaterina Sofia Bulgaria

Department of Clinical and Experimental Cardiology Amsterdam UMC Heart Center Amsterdam Cardiovascular Sciences Amsterdam The Netherlands

Hospital of Invasive Cardiology IKARDIA Nałęczów Lublin Poland

Mount Sinai Medical Center One Gustave L Levy Place Box 1030 New York NY 10029 USA

The Zena and Michael A Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai Hospital New York USA

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