Abstract 15655: Impact of Endothelial Progenitor Cell Capturing Stent on Coronary Microvascular Function: Comparison With Drug Eluting Stent
Background: Although positive effects of Drug eluting stent (DES) reduce inflammation and restenosis, negative effects delay re-endothelialization and impair microvascular function. Delayed re-endothelialization and impaired microvascular function are linked to stent thrombosis and adverse clinical outcomes after DES use. Rapid re-endothelialization by an endothelial progenitor cell capturing (EPC) stent provide a non-thrombogenic coating of the exposed stent struts. However, microvascular function related to EPC stent have been seldom investigated and reported.
METHODS: Seventy four consecutive patients undergoing percutaneous coronary intervention including stable angina and acute coronary syndrome were enrolled in the study. Microvascular function was estimated after intervention at 6-month follow-up by measuring index of microvascular resistance (IMR) and coronary flow reserve (CFR) using intracoronary pressure/temperature sensor-tipped guidewire. Thermodilution curves were obtained during maximal hyperemia. The IMR was calculated from the ratio of the mean distal coronary pressure at maximal hyperemia to the inverse of mean hyperemic transit time. The CFR was calculated dividing the resting hTmn by the bTmn.
RESULTS: Twenty one patients (age: 67.18 ± 9.55 years, M:F=15:6) received EPC stent. 53 patients (age: 61.52 ± 14.68 years, M:F=40:13) received 2ndgenerationDES. There were no significant differences in baseline clinical and angiographic characteristics. At 6-month angiographic outcomes, CFR was not significantly different in both groups. However, patients with EPC stent treatment had significant lower IMR than did patients with 2ndgeneration DES (median:25.5 [interquartile range (IQR) 12.85 to28.18] vs 29 [IQR: 15.42 to 39.23], p=0.043).
CONCLUSION: In patients receiving EPC stent, microvascular dysfunction was reduced compared with patients receiving 2nd generation DES. Rapid endothelialization by EPC stent may be desired in some patients predicting microvascular dysfunctionin DES era.
- © 2013 by American Heart Association, Inc.