title: An Internet-based registry examining the efficacy of heparin coating in patients undergoing coronary stent implantation.
abstract: BACKGROUND
  Heparin coating is an attractive alternative to counterbalance intrinsic stent thrombogenicity and to decrease the incidence of stent thrombosis.
  
  
  METHODS
  We compared, based on the data of an international multicenter prospective registry, the rates of stent thrombosis after percutaneous coronary interventions in native coronary arteries using a Bx VELOCITY heparin-coated stent versus a bare metal stent of the same design in a total of 3098 patients at high risk for stent thrombosis. Most patients in both groups underwent percutaneous coronary intervention for unstable angina (48.4% vs 47.5%, respectively) with > 25% of the patients treated for acute myocardial infarction (30.8% and 28.1%, respectively).
  
  
  RESULTS
  Procedural success was high and very similar in patients with heparin-coated and bare metal stents (99.3% vs 98.8%, respectively, P = .11). The primary end point, a 30-day stent thrombosis, occurred in 0.6% of the 1417 patients treated with the heparin-coated stent and 0.9% of the 1681 patients treated with the bare metal stent (relative risk reduction 33%, P = .41). The rates of cardiac death, myocardial infarction, and target lesion revascularization did not differ significantly between the groups. By multivariate analysis, variables independently associated with 30-day stent thrombosis included the evidence of thrombus at baseline (odds ratio [OR] 3.0, 95% CI 1.29-7.0, P = .01), small vessel stenting (OR 2.41, 95% CI 1.01-5.74, P = .05), and target left anterior descending artery (OR 2.32, 95% CI 1.00-5.38, P = .05).
  
  
  CONCLUSIONS
  This large-scale registry comparing the use of heparin-coated stent versus bare metal stent in the reality of daily practice showed no significant difference in stent thrombosis in patients with a high-risk profile for thrombotic complications.
authors.affiliation: Cardiovascular Research Foundation, New York, NY 10022, USA. rmehran@crf.org
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nikolsky
authors.forename: Edoardo
authors.initials: E
authors.lastname: Camenzind
authors.forename: Michael
authors.initials: M
authors.lastname: Zelizko
authors.forename: Igor
authors.initials: I
authors.lastname: Kranjec
authors.forename: Ricardo
authors.initials: R
authors.lastname: Seabra-Gomes
authors.forename: Manuela
authors.initials: M
authors.lastname: Negoita
authors.forename: Steven
authors.initials: S
authors.lastname: Slack
authors.forename: Chaim
authors.initials: C
authors.lastname: Lotan
mesh_terms: D000789:Angina, Unstable / Q000601:surgery; D000925:Anticoagulants / Q000008:administration & dosage; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D023903:Coronary Restenosis / Q000517:prevention & control; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D020407:Internet; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery; D012042:Registries; D015607:Stents; D016019:Survival Analysis; D013608:Tablets, Enteric-Coated; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D013608:Tablets, Enteric-Coated; D006493:Heparin