Mobilization of progenitor cells and vessel healing after implantation of SYNERGY in acute coronary syndrome
Masashi Sakuma, Setsu Nishino, Takahisa Nasuno, Michiya Kageyama, Michiaki Tokura, Ryoichi Sohma, K. Inoue, Tomoaki Kanaya, Syotaro Obi, Shigeru Toyoda, Shichiro Abe, Guiherme F. Attizzani, Gabriel Tensol Rodrigues Pereira, Hiram G. Bezerra, Teruo Inoue
Abstract
Abstract 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+/CD45 null 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+/CD45 null 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.