AHA 2008: New stent entices progenitor cells, has low rate of thrombosis

New Orleans-A new type of stent coated with an antibody that binds circulating endothelial progenitor cells (EPCs) is associated with a low rate of stent thrombosis and requires only 1 month of dual antiplatelet therapy. Drug-eluting stents require at least 6 months of dual antiplatelet therapy to reduce the risk of stent thrombosis.

The EPC-capturing stent is coated with CD34+ that binds circulating EPCs that differentiate into a functional endothelium to accelerate healing, reduce neointimal hyperplasia and smooth-muscle-cell proliferation with the intent of preventing stent thrombosis.

One-year results from two open-label studies of the EPC-capturing stent were reported here.

Investigators at the Academic Medical Center of the University of Amsterdam, The Netherlands, studied the EPC-capturing stent in 236 patients with mainly complex coronary stenoses. Most of the patients were treated with statins for 1 week prior to stent implantation; statins increase the number of EPCs in the blood.

According to Margo Klomp, MD, lead investigator of the study and a medical fellow at the Academic Medical Center, two patients (0.8 percent) died from cardiac causes, 10.2 percent required a repeat revascularization of the target vessel, 2.5 percent suffered a myocardial infarction (MI), and 1.2 percent had a stent thrombosis.

In an international study, the EPC-capturing stent was implanted in 1,640 patients, 36.7 percent of whom had a previous MI. About three fourths were pretreated with statins.

One percent had a stent thrombosis, 2.1 percent died of cardiac causes, 5.4 percent required a repeat revascularization procedure on the target artery, and 9.3 percent suffered a major adverse cardiac event, reports Sigmund Silber, MD, chief of cardiology at Müller Hospital Munich, Germany.

Among the patients with diabetes, who comprised about 25 percent of the cohort, 4.7 percent underwent another revascularization procedure, 1.1 percent had a stent thrombosis, and 10.3 percent had major adverse cardiac events.

The EPC-capturing stent will be a good alternative when interventionalists choose not to use a drug-eluting stent, says Dr. Silber.