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A Journal on Heart and Vascular Diseases
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2013 June;61(3):301-11
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)
Wojakowski W. 1, Pyrlik A. 1, Król M. 2, Buszman P. 2, Ochała A. 1, Milewski K. 2, Smolka G. 1, Kawecki D. 3, Rudnik A. 2, Pawłowski T. 1, Jadczyk T. 1, Wyderka R. 1, Cybulski W. 1, Dworowy S. 1, Tendera M. 1 ✉
1 Third Division of Cardiology Medical University of Silesia, Katowice, Poland;
2 American Heart of Poland, Ustron, Poland;
3 Division of Cardiology Medical University of Silesia, Zabrze, Poland
Aim: 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. Inclusion criteria: de novo lesion >70% in native vessel, diameter 2.5-4 mm, lesion length <30 mm. Exclusion criteria: 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).
Conclusion: 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).