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.
Conclusion: 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.