The REMEDEE trial: 5‐Year results on a novel combined sirolimus‐eluting and endothelial progenitor cells capturing stent

• Published in: Catheterization and cardiovascular interventions 2020-05, Vol.95 (6), p.1076-1084
• Main Authors: Haude, Michael, Lee, Stephen W. L., Worthley, Stephen G., Silber, Sigmund, Verheye, Stefan, Rosli, Mohd A., Botelho, Roberto, Sim, Kui H., Abizaid, Alexandre, Mehran, Roxana
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - adverse effects; Coronary artery; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - pathology; Coronary Artery Disease - therapy; Coronary Restenosis - etiology; Coronary Thrombosis - etiology; Drug-Eluting Stents; Endothelial Progenitor Cells - pathology; Female; Humans; Implants; Male; Middle Aged; Myocardial infarction; percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - mortality; Progenitor cells; progenitor endothelial cells; Prospective Studies; Rapamycin; Restenosis; Risk Factors; sirolimus; Sirolimus - administration & dosage; Sirolimus - adverse effects; Stem cells; Stents; Thrombosis; Time Factors; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.28483

Objectives To evaluate the long‐term safety and efficacy of the novel combined sirolimus‐eluting endothelial progenitor cell capture Combo stent (OrbusNeich, Fort Lauderdale, FL) at 5 years in the REMEDEE (Randomized study to Evaluate the safety and effectiveness of an abluMinal sirolimus coated bio‐Engineered stEnt) trial. Background Drug–eluting stents have limited restenosis and reintervention but are complicated by late and very late thrombosis and accelerated neoatherosclerosis. Alternative or adjunctive technologies are needed to address these limitations. Methods A total of 183 patients with de novo lesions in native coronary arteries were randomized 2:1 to Combo (n = 124) or Taxus Liberté (n = 59). Primary endpoint was 9 month angiographic in‐stent late lumen loss and the secondary endpoint was the occurrence of major adverse events (MACE) through 5‐year follow‐up. Results Compared with Taxus, after 5 years the Combo stent was associated with similar rates of MACE (18.3% vs. 16.9%, p = .89), cardiac death (0.8% vs. 5.1%, p = .07), myocardial infarction (4.1% vs. 3.4%, p = .81), target lesion (9.4% vs. 10.2%, p = .78), and target vessel revascularization (14.4% vs. 11.9%, p = .73). No cases of definite stent thrombosis were reported in the Combo group. The follow‐up rate at 5 years was 97.7%. Conclusion At 5‐year follow‐up, the Combo stent remained clinically safe and effective with an overall low rate of MACE comparable to Taxus.