Reduction of subacute stent thrombosis (SAT) using heparin-coated stents in a large-scale, real world registry.
OBJECTIVE
This study was designed to compare the rates of subacute stent thrombosis (SAT) among patients receiving heparin-coated stents to patients receiving bare-metal stents in real world, contemporary coronary interventions.


BACKGROUND
Controlled trials with heparin-coated coronary stents have shown a trend toward decreased rates of SAT.


RESULTS
The data in this study were collected from a single, large cardiac center over a period of 9 months. All patients who underwent coronary stent implantation during this 9-month period were included in the study (1,288 patients; 1,366 procedures; 2,231 stents). All patients were treated with aspirin and clopidogrel (or ticlopidine) after stenting. Primary thrombotic outcome was defined as angiographically documented SAT and/or sudden unexplained cardiac death (SCD) within 30 days of the procedure. Follow-up data (1,264/1,276 patients) were obtained in 99% of patients. A total of 337 patients received 543 heparin-coated stents (BX Velocity Hepacoat) and 939 patients received bare-metal stents (1,688 stents). SAT was seen in 25/1,024 procedures (2.44%) in the bare-metal stent group and 1/342 procedures (0.29%) in the heparin-coated stent group. Primary thrombotic outcomes (SAT or SCD) were observed in 31/1,024 procedures (3.03%) in the bare-metal stent cohort and in 2/342 procedures (0.58%) in the heparin-coated stent group. The vast majority (96%) of the patients who had SAT within 30 days had initial stent placement for an acute coronary syndrome (p<0.0001).


CONCLUSIONS
This large, single-center registry demonstrates a significant reduction of SAT using heparin-coated stents compared to bare-metal stents in real world coronary interventions.
Gupta
Vishal
V
Borgess Heart Institute, Kalamazoo, Michigan 49001, USA.
Aravamuthan
Bhooma R
BR
Baskerville
Susan
S
Smith
Susan K
SK
Gupta
Vijaya
V
Lauer
Michael A
MA
Fischell
Tim A
TA
D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage*; D020099:Coated Materials, Biocompatible; D003331:Coronary Vessels; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D015996:Survival Rate; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D006493:Heparin