Long Term Clinical Follow-up of Carbon Coated Stents: Comparative Study with Bare-Metal Stents
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- Category: Vol. 82, March 2014
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Long Term Clinical Follow-up of Carbon Coated Stents: Comparative Study with Bare-Metal Stents, KHALED M. TAEMA and AYMAN N. MOHARRAM
Abstract
Background: Despite the use of coronary stents, restenosis is still a significant problem. Hypersensitivity to metals of the stent was supposed as one of the mechanisms of initiating restenosis. Accordingly, coating of the stents with an inert material as carbon film might decrease restenosis. We intended in this study to evaluate the carbon coated stents in terms of long term clinical outcomes compared to baremetal stents.
Methods: We followed a cohort of 1000 patients with elective percutaneous coronary intervention (PCI) using 1 stent for de-novo, native vessel lesion. Every patient had implanted either carbon coated stents (CCS) or bare-metal stents (BMS). We excluded patients with multi-vessel PCI, PCI to graft vessel or restenotic lesion, and recent MI within 72 hours of admission. Patients were followed for occurrence of major adverse cardiac events (MACE) both on short terms during hospital stay and on long term in yearly basis for an average of 2.4±1.2 years.
Results: Our patient population had a mean age of 53.7±9.2 years old, 809 male (80.9%), 191 female (19.1%). Patients of CCS group were 300 patients (30%) and those of BMS group were 700 patients (70%). Apart from gander, presence of peripheral vascular disease, target vessel, lesion length, and used stent diameter, the baseline demographic, clinical, and angiographic parameters were similar in both groups. Successful stent deployment was achieved in all patients with similar in hospital complications in both groups. The patients were followed for 2.4±1.2 years. The incidence of MACE was similar in both groups in the first 2 years of follow-up (6.3 % and 6.7% for CCS vs 7. 1 % and 4.6% for BMS in the 1st and 2nd years respectively, p=0.4 and 0.1). During the 3rd and 4th years, MACE occurred significantly more in the CCS group (2.7% and 2.3%, for CCS vs 1. 1 % and 1 % for BMS in the 3rd and 4th years respectively, p=0.05 and 0.01). However after adjustment for the baseline characteristic (e.g. gender and stent size) using the cox regression analysis, the MACE-free survival was found to be similar in both groups.
Conclusion: Despite the high success rate and low event rate with CCS, it revealed no superiority over BMS in the long term clinical follow-up.