Author + information
- Giovanna Sarno1,
- Bo Lagerqvist1,
- Göran Olivecrona2,
- Christoph Varenhorst1,
- Mikael Danielewicz3,
- Kristina Hambraeus4,
- Agneta Johansson5,
- Truls Råmunddal6,
- Nils Witt7 and
- Stefan James1
- 1Cardiology department and Uppsala Clinical Research Center, Uppsala, Sweden
- 2Department of Cardiology, Lund University, Lund, Sweden
- 3Cardiology department, Karlstad, Sweden
- 4Cardiology department, Falun, Sweden
- 5Cardiology department, Sunderbyn, Sweden
- 6Cardiology department, Gothenburg, Sweden
- 7Cardiology department Södersjukhuset, Stockholm, Sweden
In unselected patients from a nationwide registry we describe the initial real-world experience with a novel everolimus eluting platinum chromium stent with biodegradable polymer (SYNERGY).
All implanted SYNERGY stents were compared to all new generation DES (n-DES) with more than 1000 implantations in Sweden between March 2013 and October 2015. The results were assessed using propensity score and Cox regression analyses. A subgroup analysis was performed in patients with acute coronary syndromes (ACS).
A total of 7,886 of SYNERGY stents and 58,004 other n-DES (BioMatrix, N=1,953; Orsiro, N= 4,946; Promus Element Plus, N= 2,543; Promus Premier, N= 20,414; Xience Xpedition, N= 7971, Resolute/Resolute Integrity, N=19021; Ultimaster, N=1156; Resolute Onyx, N=6425) were implanted during 42,357 procedures. The baseline clinical and procedural characteristics are shown in table 1. Restenosis occurred in 525 and ST in 282 cases, respectively, in the total population up to 1 year. The cumulative rate of restenosis up to 1 year in the Synergy group was not significantly different from the other n-DES group (1.2% vs. 1.0%, adjusted HR: 1.24 95% CI: 0.88-1.75; p=0.21). The cumulative rate of ST up to 1 year in the Synergy group was low and not significantly different from the other n-DES group (0.2% vs. 0.5%, adjusted HR: 0.68; 95% CI: 0.38-1.19; p=0.17). No ST events were observed in the Synergy group after 6 months.
Similarly in ACS patients, there was no significant difference in ST rates up to 1 year between SYNERGY and other n-DES (0.3% vs. 0.7%; adjusted HR: 0.69; 95% CI: 0.37-1.37; p=0.29).
In a large real-world population the SYNERGY stent appears to be safe and effective with a low rate of restenosis and ST comparable with other n-DES. The risk of ST up to 1 year is similarly low also in patients with ACS.
|Age, years, mean||68.0 ± 10.8||67.6 ± 10.8||0.02|
|Women (%)||1191 (28.0)||9697 (25.4)||<0.01|
|Diabetes (%)||981 (23.1)||8346 (21.9)||<0.01|
|NSTEMI (%)||14384 (37.2)||14384 (37.7)||NS|
|STEMI (%)||1017 (23.9)||9261 (24.3)||NS|
|SA (%)||1031 (24.3)||9300 (24.4)||NS|
|UA (%)||412 (9.7)||3751 (9.8)||NS|