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急性冠脉综合征中植入 SYNERGY 后祖细胞的动员和血管愈合。

Mobilization of progenitor cells and vessel healing after implantation of SYNERGY in acute coronary syndrome.

机构信息

Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.

Advanced Medical Science Research Center, Dokkyo Medical University, Mibu, Tochigi, Japan.

出版信息

Sci Rep. 2021 Aug 27;11(1):17315. doi: 10.1038/s41598-021-96730-9.

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 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 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.

摘要

本研究旨在比较急性冠脉综合征(ACS)患者中 SYNERGY 支架与 PROMUS PREMIER 支架的血管愈合过程。在 71 例接受 SYNERGY 支架(n=52)或 PROMUS PREMIER 支架(n=19)冠状动脉支架植入术的 ACS 患者中,我们通过光学相干断层扫描(OCT)和冠状动脉血管镜观察支架部位的血管愈合,并测量循环 CD34+/CD133+/CD45 细胞和 CD34+/KDR+细胞。在第 7 天,SYNERGY 组循环 CD34+/CD133+/CD45 细胞增加(P<0.0001),而 PROMUS 组无变化。SYNERGY 组 CD34+/KDR+细胞也增加(P<0.0001),但 PROMUS 组变化较小(P<0.05)。与 PROMUS 组相比,SYNERGY 组在 12 个月时基于 OCT 的新生内膜厚度(P<0.0005)和新生内膜覆盖率(P<0.05)更高。12 个月时,基于冠状动脉血管镜的新生内膜覆盖率分级也更高(P<0.001)。在所有患者中,第 7 天 CD34+/KDR+细胞的变化与 12 个月时基于 OCT 的新生内膜厚度相关(R=0.288,P<0.05)。SYNERGY 支架在支架部位血管愈合方面似乎比 PROMUS PREMIER 支架对 ACS 患者具有潜在优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49c2/8397756/98ab7a99937b/41598_2021_96730_Fig1_HTML.jpg

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