Background
Clinical trials of drug-eluting stenting (DES) have demonstrated a marked reduction in the incidence of restenosis compared to bare metal stents. However, concerns have risen regarding the long-term safety of DES. The Endothelial Progenitor Cell (EPC)-capturing stent is coated with an antibody (CD34+) that binds circulating EPCs which differentiate into a functional endothelial layer. This accelerated healing may reduce in-stent restenosis by reducing neointimal hyperplasia and smooth muscle cell proliferation and, in addition, may prevent stent thrombosis(ST). In this single center study, we report the 1-year clinical outcome in patients treated with an EPC-capturing stent.
Methods
Between September 2005 and March 2007, 257 patients were treated with an EPC-capturing stent for coronary artery stenosis and 236 patients had completed 1-year follow-up. Dual anti-platelet therapy was prescribed for at least 1 month.
Results
Mean age of the population was 65 years, 72% were male, and 14% were diabetic patients. Three patients had a contra-indication for treatment with a DES, receiving only 2 weeks of clopidogrel post-PCI. A total of 282 lesions were treated of which 252 lesions were treated with an EPC-capturing stent. Of the lesions treated with an EPC-capturing stent, 64% were type B2 or C lesions according to ACC/AHA classification, 16% were CTO and 23% were bifurcated lesions, reflecting daily practice. Mean stent length was 25.13±12.02 mm and mean stent diameter was 3.27±0.36 mm. At 1-year clinical follow-up, 3.0% of the patients died of which 0.8% died from a cardiac cause, and 2.5% of all patients suffered a myocardial infarction. Target vessel revascularization was 9.7% and definite ST was 1.2% (occurring within 24 hours, at 7, and 18 days respectively). At 1-year clinical follow-up the cumulative MACE rate was 11.4%.
Conclusion
In this single center study, PCI of predominantly complex lesions with a Genous
™
EPC-capturing stent shows excellent 1-year clinical outcomes. Furthermore, using this stent avoids the need for long-term dual anti-platelet therapy.
TCT-298: Does Xience V Stent Reduce the Clinical Outcome Gap Between Diabetic and Non-Diabetic Patients? A Long-Term Single-Center Analysis