title: Initial Experience of Bioabsorbable Polymer Everolimus-Eluting Synergy Stents in High-Risk Patients Undergoing Complex Percutaneous Coronary Intervention With Early Discontinuation of Dual-Antiplatelet Therapy.
abstract: OBJECTIVE
  As more elderly and co-morbid patients require percutaneous revascularization, 1 year of dual-antiplatelet therapy (DAPT) becomes concerning. Synergy stents (Boston Scientific) allow for early cessation of DAPT. This study assessed those in our unit who underwent percutaneous coronary intervention (PCI) with a Synergy stent to examine a minimum of 6 months of clinical outcomes after early discontinuation of DAPT.
  
  
  RESULTS
  All non-trial patients in our unit who had PCI with a Synergy stent from August 2013 to February 2016 were retrospectively analyzed. Follow-up was by medical record review or direct contact for postprocedural complications or adverse events. In total, 185 patients underwent PCI with a Synergy stent over 1 year prior. The mean patient age was 72.0 ± 11.0 years (range, 41-97 years). Stenting involved left main stem (14.1%), multivessel disease (33.0%), and chronic total occlusion (33.0%). DAPT discontinuation occurred in 78.4% by 3 months with no stent thrombosis. Three patients required target-vessel revascularization (TVR) by 1 year. There were no cardiac deaths or myocardial infarctions. Twenty-five patients were able to have non-cardiac procedures within the study period.
  
  
  CONCLUSIONS
  The use of the Synergy everolimus-eluting stent allows for early discontinuation of DAPT, reducing risk of bleeding complications and facilitating non-cardiac procedures, without an increase in stent thrombosis and with excellent results for TVR.
authors.affiliation: Cardiology Department, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern Ireland. rnoad01@qub.ac.uk.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Noad
authors.forename: Colm G
authors.initials: CG
authors.lastname: Hanratty
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Walsh
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011108:Polymers; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D011108:Polymers; D000068338:Everolimus