The Supraflex Cruz stent is noninferior to the SYNERGY stent in treating patients with de novo 3-vessel disease and chronic coronary syndrome, results from the TALENT study reveal. Patrick W. Serruys, MD, PhD, from the University of Ireland, Galway, presented these results during a late-breaking clinical science session on Tuesday at the Transcatheter Cardiovascular Therapeutics (TCT) 2025 conference in San Francisco. The TALENT randomized clinical trial investigators sought to determine the “best practice” for patients with de novo 3-vessel disease without LM and with CCS ( non-ST-segment myocardial infarction [NSTEMI] and unstable angina) by comparing the Supraflex Cruz sirolimus-eluting coronary stent (SMT) versus the SYNERGY stent (Boston Scientific). A total of 774 patients were randomized to receive Supraflex Cruz (CCS=48.8%, NSTEMI=38.1%, unstable angina=13.0%) and 774 patients were randomized to receive SYNERGY (CCS=47.8%, NSTEMI=41.2%, unstable angina=11.0%). The primary endpoint (for noninferiority)of the study was a patient-oriented composite endpoint (POCE) of all-cause death, any myocardial infarction, stroke and any revascularization at 12-months post-procedure. The noninferiority margin was 4.28% (risk ratio=1.4). Results for the overall POCE endpoint showed that Supraflex Cruz was noninferior to SYNERGY (risk difference=0.73%; two-sided 95% confidence interval [CI]: -2.68 to 4.31; p=0.691). Similarly, individual components of the primary endpoint did not significantly differ across the two groups. Bleeding rates according to the BARC criteria also had no significant differences. “While the non-inferiority margin of 5.83% based on the observed event rate of 14.6%, which results in a p-value for non-inferiority of less than 0.001,” said Dr. Serruys during a TCT press conference Tuesday morning. “It is notable that in the high SYNTAX Score, there is a swap in the cumulative rate of events: 22.8% in the SYNERGY arm and 14.6%in the Supraflex Cruz. The p-value for the Log rank is not significant [p=0.167].” Overall, no significant differences were seen between the SYNERGY and Supraflex Cruz groups at 12-months, indicating that the Supraflex Cruz device is noninferior to the SYNERGY device. Dr. Serruys concluded his presentation at TCT by naming some “best practices” in utilizing the results from this study: follow the European Society of Cardiology (ESC) guidelines, treat only the lesions with a delta angio-derived fractional flow reserve (FFR) of greater than or equal to 0.05, use contemporary techniques, use intravascular imaging guidance to optimize stenting and use P2Y12 inhibitors as monotherapy after 30-days post-percutaneous coronary intervention. Image Caption: Patrick W. Serruys, MD, PhD, presents during a press conference Tuesday, October 28, at the Transcatheter Cardiovascular Therapeutics (TCT) 2025 conference in San Francisco. Image Credit: Screenshot by Bailey G. Salimes, CRTonline.org.