title: Effectiveness and safety of the genous endothelial progenitor cell-capture stent in acute ST-elevation myocardial infarction.
abstract: The endothelial progenitor cell (EPC)-capture stent promotes endothelialization and preliminary studies have suggested its safety and feasibility in ST-elevation myocardial infarction (STEMI). Detailed late clinical follow-up and angiographic analyses are, however, limited. We sought to determine late angiographic and clinical outcomes of the Genous EPC-capture stent in primary angioplasty. EPC-capture stents were implanted during primary angioplasty in 489 consecutive patients presenting with STEMI from 2004 through 2008. The first 100 consenting patients undergoing successful stent implantation scheduled to undergo relook coronary angiography at 6 to 12 months were enrolled. Ninety-five patients with 96 lesions were analyzed independently. Mean duration of follow-up coronary angiography was 245 days. In-stent late luminal loss measured 0.87 ± 0.67 mm. Binary restenosis (defined as >50% diameter stenosis) was 28%, with diffuse in-stent restenosis (Mehran class II) as the predominant pattern. Of 27 patients with binary restenosis, 14 (52%) were symptomatic, with 10 patients undergoing target lesion revascularization. Asymptomatic patients had significantly larger reference vessel and in-stent minimal luminal diameters (2.77 ± 0.39 vs 2.54 ± 0.44 mm, p = 0.040; 2.74 ± 0.34 vs 2.31 ± 0.72 mm, p = 0.004, respectively). Follow-up late loss and diameter stenoses were also in favor of the asymptomatic group. Major adverse cardiac event rate was 16% at a mean follow-up of 34 months. There were no cases of Academic Research Consortium-defined stent thrombosis. In conclusion, implantation of the EPC-capture stent during primary angioplasty is associated with a favorable late clinical outcome but with higher than anticipated angiographic late loss.
authors.affiliation: National University Heart Centre, Singapore. mdclowa@nus.edu.sg
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Low
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
authors.forename: Swee-Guan
authors.initials: SG
authors.lastname: Teo
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
authors.forename: Edgar
authors.initials: E
authors.lastname: Tay
authors.forename: Yian-Ping
authors.initials: YP
authors.lastname: Lee
authors.forename: Eric
authors.initials: E
authors.lastname: Chong
authors.forename: Melissa
authors.initials: M
authors.lastname: Co
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tin Hay
authors.forename: Yean-Teng
authors.initials: YT
authors.lastname: Lim
authors.forename: Huay-Cheem
authors.initials: HC
authors.lastname: Tan
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004730:Endothelium, Vascular / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D013234:Stem Cells; D015607:Stents
chemical_list: D020099:Coated Materials, Biocompatible