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.
- Klíčová slova
- Acute coronary syndrome, Anti-CD34, Dual therapy stent, Endothelial progenitor cell capture, Percutaneous coronary intervention,
- MeSH
- akutní koronární syndrom klasifikace komplikace mortalita chirurgie MeSH
- časové faktory MeSH
- endoteliální progenitorové buňky metabolismus MeSH
- infarkt myokardu klasifikace komplikace MeSH
- koronární angioplastika metody MeSH
- koronární trombóza epidemiologie MeSH
- lidé MeSH
- nestabilní angina pectoris komplikace MeSH
- protézy - design MeSH
- rizikové faktory MeSH
- sirolimus aplikace a dávkování MeSH
- stenty uvolňující léky škodlivé účinky statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- sirolimus MeSH
- MeSH
- adaptivní imunita MeSH
- akutní koronární syndrom krev diagnóza terapie MeSH
- antigeny CD44 genetika MeSH
- antikoagulancia terapeutické užití MeSH
- aterosklerotický plát komplikace MeSH
- biologické markery krev MeSH
- časná diagnóza MeSH
- diagnostické techniky kardiovaskulární MeSH
- duální protidestičková léčba MeSH
- exprese genu MeSH
- GPI-vázané proteiny genetika MeSH
- hodnocení rizik MeSH
- hyaluronoglukosaminidasa genetika MeSH
- hypolipidemika terapeutické užití MeSH
- infarkt myokardu klasifikace diagnóza terapie MeSH
- koronární angioplastika metody MeSH
- lidé MeSH
- magnetická rezonance kinematografická MeSH
- molekuly buněčné adheze genetika MeSH
- oxygenoterapie MeSH
- přirozená imunita MeSH
- remodelace cév MeSH
- ruptura MeSH
- sexuální faktory MeSH
- srdce diagnostické zobrazování MeSH
- statiny terapeutické užití MeSH
- stenty MeSH
- takotsubo kardiomyopatie klasifikace diagnóza mortalita MeSH
- transportní proteiny krev MeSH
- troponin krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antigeny CD44 MeSH
- antikoagulancia MeSH
- biologické markery MeSH
- CD44 protein, human MeSH Prohlížeč
- GPI-vázané proteiny MeSH
- Hyal2 protein, human MeSH Prohlížeč
- hyaluronoglukosaminidasa MeSH
- hypolipidemika MeSH
- molekuly buněčné adheze MeSH
- myosin-binding protein C MeSH Prohlížeč
- statiny MeSH
- transportní proteiny MeSH
- troponin MeSH
In clinical practice the use of terms transmural and non-transmural infarction, based on the evaluation of the electrocardiogram is abandoned, as the correlation of an abnormal Q wave and transmural infarction and its absence in non-transmural ischaemic lesions is inadequate. A cardiac infarction with a Q wave and a non-Q wave infarction have certain different clinical and prognostic characteristics. A non-Q infarction is characterized during hospitalization usually by more frequent episodes of angina pectoris and a lower mortality than infarction with a Q wave. The depression of the ST segment in a standard electrocardiogram in acute coronary attacks is not a more benign phenomenon than its elevation. From the aspect of long-term prognosis the sub-group of patients specially at risk are those with marked depressions of the ST segment. A non-Q infarction, even if of smaller extent, is an unstable form of ischaemic heart disease and therefore in these patients more intense and post-hospitalization monitoring for a so-called vulnerable heart muscle is justified. The basic classification of the ECG in acute coronaries into infarctions with and without a Q wave is inadequate, unless based on the corresponding pathological correlate as patients with non-Q infarctions are not a homogeneous group. The way to obtain optimal electrocardiographic informations and their classification in acute myocardial infarction is to evaluate electrocardiograms where not only changes in the initial portion of the QRS complex are evaluated but also changes in its medium and end portions, changes of ST segments and T waves as well as their combinations, distribution and duration.
- MeSH
- elektrokardiografie * MeSH
- infarkt myokardu klasifikace komplikace diagnóza MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- elektrokardiografie MeSH
- infarkt myokardu klasifikace patofyziologie MeSH
- lidé MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- dospělí MeSH
- hemodynamika * MeSH
- infarkt myokardu klasifikace patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
