Clinical and angiographic outcomes in elderly patients treated with endothelial progenitor cell capture coronary stents: results from a prospective single-center registry.
OBJECTIVE
To evaluate the outcomes in elderly patients treated with endothelial progenitor cell (EPC) capture stent, designed to promote rapid stent endothelialization, and dual-antiplatelet therapy for only 1 month.


BACKGROUND
Although some registries showed that drug-eluting stents have better clinical outcomes and can reduce reinterventions in comparison to bare-metal stents in elderly patients, the subsequent prolonged dual-antiplatelet therapy needed after drug-eluting stent implantation can likely be interrupted because of intolerance or comorbidities in this subset of patients, with high risk of stent thrombosis.


METHODS
One hundred consecutive patients ≥ 75 years with de novo lesions in native coronary arteries underwent EPC capture stent implantation. The study endpoints were major adverse cardiac events (MACE), binary restenosis and late lumen loss.


RESULTS
Mean age was 79 ± 3 years (78% male), 28% had diabetes, and 81% had non-ST-elevation acute coronary syndrome. A total of 134 lesions were treated, 69% were type B2/C, and 143 EPC capture stents were implanted (1.4 stents per patient). At 1-year follow up, clinical outcomes were: all-cause death, 8%; myocardial infarction, 2%; clinically-justified target lesion revascularization (TLR), 22%; MACE, 28%; and definite stent thrombosis, 2% (2 cases in the same patient). Angiographic 6-month follow up showed a binary restenosis rate of 35% and a late lumen loss of 0.94 ± 0.86 mm.


CONCLUSIONS
This study suggests that EPC capture stent is safe and feasible in patients ≥ 75 years of age, but clinically justified TLR and binary restenosis were frequently observed.
Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy. azzarelli.s@tiscali.it
Salvatore
S
Azzarelli
Alfredo R
AR
Galassi
Giuseppe
G
Grosso
Davide
D
Tomasello
Barbara
B
Campisano
Michele
M
Giacoppo
Vincenzo
V
Argentino
Francesco
F
Amico
Antonio
A
Fiscella
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013234:Stem Cells / Q000166:cytology*; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome