title: Circulating endothelial progenitor cells are inversely correlated with in-stent restenosis in patients with non-ST-segment elevation acute coronary syndromes treated with EPC-capture stents (JACK-EPC trial).
abstract: OBJECTIVE
  Aim of the study was to evaluate the association between circulating endothelial progenitor cells (EPCs) and angiographic outcomes after implantation of GenousTM stent in patients with non-ST-segment elevation acute coronary syndromes (ACS) (NSTE-ACS) undergoing urgent percutaneous coronary intervention (PCI).
  
  
  METHODS
  Sixty patients treated with EPC-capture stent (N.=30) or bare metal stents (BMS) (N.=30) receiving 80 mg atorvastatin and dual antiplatelet therapy (DAT) for 12 months. Restenosis was assessed after 6 months by quantitative coronary angiography (QCA) and major acute coronary events (MACE) evaluated after 6 and 12 months.
  
  
  METHODS
  de novo lesion >70% in native vessel, diameter 2.5-4 mm, lesion length <30 mm.
  
  
  METHODS
  diabetes, previous revascularization, significant left main stenosis, chronic total occlusions (CTO) and multivessel disease.
  
  
  RESULTS
  Majority of patients in EPC-capture stent and BMS groups presented with NSTEMI (73.3% and 70%, respectively). Mean stent length was 20.1±8 and 19.9±10 mm, diameter 3±0.97 and 3.1±0.88 mm in respective groups. The binary restenosis was significantly lower in GenousTM (13 vs. 26.6%, P=0.04). Risk of MACE after 6 and 12 months were comparable in both groups. There was no stent thrombosis. Numbers of circulating EPCs were significantly approximately 2-fold higher during the ACS than after 6 months. Mobilization of EPCs during acute ischemia was significantly lower in patients who developed restenosis after 6 months (3 vs. 4.5 cells/μL, P=0.002) and it was negatively correlated with late-loss after 6 months (R=-0.42; P<0.03).
  
  
  CONCLUSIONS
  Use of GenousTM stents in NSTE-ACS is associated with lower restenosis rate than BMS at 6 months. There was no ST through 1 year. The number of circulating EPCs is inversely correlated with in-stent late loss (LL).
authors.affiliation: Third Division of Cardiology, Medical University of Silesia, Katowice, Poland. wojtek.wojakowski@gmail.com
authors.forename: W
authors.initials: W
authors.lastname: Wojakowski
authors.forename: A
authors.initials: A
authors.lastname: Pyrlik
authors.forename: M
authors.initials: M
authors.lastname: Król
authors.forename: P
authors.initials: P
authors.lastname: Buszman
authors.forename: A
authors.initials: A
authors.lastname: Ochała
authors.forename: K
authors.initials: K
authors.lastname: Milewski
authors.forename: G
authors.initials: G
authors.lastname: Smolka
authors.forename: D
authors.initials: D
authors.lastname: Kawecki
authors.forename: A
authors.initials: A
authors.lastname: Rudnik
authors.forename: T
authors.initials: T
authors.lastname: Pawłowski
authors.forename: T
authors.initials: T
authors.lastname: Jadczyk
authors.forename: R
authors.initials: R
authors.lastname: Wyderka
authors.forename: W
authors.initials: W
authors.lastname: Cybulski
authors.forename: S
authors.initials: S
authors.lastname: Dworowy
authors.forename: M
authors.initials: M
authors.lastname: Tendera
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology* / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000069059:Atorvastatin; D020099:Coated Materials, Biocompatible; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000009:adverse effects; D042783:Endothelial Cells; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology; D006538:Heptanoic Acids / Q000008:administration & dosage; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage; D011859:Radiography; D012307:Risk Factors; D013234:Stem Cells; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin