Randomized Comparison of Endothelial Progenitor Cells Capture Stent Versus Cobalt-Chromium Stent for Treatment of ST-Elevation Myocardial Infarction. Six-Month Clinical, Angiographic, and IVUS Follow-Up
Abstrakt
The aim of this trial was to assess the feasibility and safety of endothelial progenitor cells capture (EPC) stent in the treatment of acute ST-elevation myocardial infarction (STEMI) when compared with cobalt-chromium stents (CoCr). Methods: Between July 2006 and May 2008, 100 patients with single vessel disease undergoing primary PCI for STEMI were randomly assigned to receive either EPC stent (N = 50) or CoCr stent (N = 50).
High-pressure stent implantation was carried out in both groups. Dual antiplatelet treatment was administered for 30 days in both groups.
All patients underwent 6-month clinical, angiographic, and IVUS follow-up. Results: The rate of major adverse cardiovascular events (MACEs) at 30 days was comparable in both groups.
At 6-month follow-up, the rates of MACEs and TLR in the EPC stent group when compared with CoCr stent were 24% vs.10%; P = 0.06 and 14% vs. 4%; P = 0.08, respectively. There were three cases (6%) of stent thrombosis (ST) in the EPC stent group versus none in CoCr group.
Conclusion: The use of EPC capture stents in the setting of STEMI is feasible and safe in terms of 30-days outcome. However, at the 6-month follow-up, we found a trend of higher rates of MACE and TLR in the EPC stent capture group compared to CoCr stents.
The study does not support the use of EPC capture stents with short duration dual antiplatelet therapy in patients with STEMI. Future randomized studies with large sample sizes would be necessary to demonstrate the safety of such approach