Stents convencionais de aço inoxidável vs. cromo-cobalto: impacto clínico da liga metálica no cenário atual - registro InCor

Abstract

Stainless Steel versus Cobalt-Chromium Bare Metal Stents: Clinical Impact of the Metal Alloy in a "Real World" ScenarioInCor RegistryBackground: Years ago studies demonstrated that the use of cobalt-chromium stents with thinner struts significantly reduced coronary restenosis when compared to conventional stainless steel stents available at the time. Since then, stents with struts < 100 µm and different metal alloys are available for clinical use. The objective of this study was to assess differences in the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) with thin strut stents and different metal alloys. Methods: Single center registry comparing the results of patients undergoing PCI with stainless steel stents (n = 135) vs. cobalt-chromium bare metal stents (n = 181). The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined by death, acute myocardial infarction (AMI) or target vessel revascularization (TVR) in the late follow-up. Results: Mean patient age was 64 ± 11 years, 32.6% were diabetic and 65.5% had acute coronary syndrome at admission, with no differences for most of the clinical and angiographic characteristics assessed between groups. The use of direct stenting was more frequent in the cobalt-chromium group (30.3% vs. 40.2%; P = 0.04). After a median of 500 days of follow up, there was no statistically significant difference between groups for the occurrence of MACE (15.5% vs. 16.5%; P = 0.6), death (4.6% vs. 6.8%; P = 0.29), AMI (2.7% vs. 4.1%; P = 0.41) or TVR (10.4% vs. 10.1%; P = 0.97). Conclusions: In this real world population, cobaltchromium stents had similar efficacy and safety when compared to stainless steel stents, but with less coronary instrumentation.