Influence of metal alloy and the profile of coronary stents in patients with multivessel coronary disease

Abstract

BACKGROUND:In Brazil, despite the recommendations of the Brazilian Society of Hemodynamics and Interventional Cardiology, the National Health System has not yet approved the use of drug-eluting stents. In percutaneous coronary interventions performed in the public and part of the private health care system, bare metal stents are used as the only option. Therefore, new information on bare metal stents is of great importance. The primary endpoint was to evaluate the influence of the alloy and the profile of coronary stents on late loss and restenosis rates 6 months after implantation in patients with multivessel coronary disease.METHODS:Single center, randomized and prospective study comparison of cobalt–chromium versus stainless steel stent implantation in 187 patients with multivessel coronary disease. At least one cobalt–chromium and one stainless steel stent were implanted per patient.RESULTS:Mean age of patients was 59.5±10.1 years with a prevalence of males (66.3%) and patients with acute coronary syndrome (56%). Baseline clinical characteristics were similar with hypertension in 146 (78%), dyslipidemia in 85 (45.5%) and diabetes in 68 (36.4%). Two hundred and twenty-nine cobalt–chromium and 284 stainless steel stents were implanted. Angiographic variables showed no statistically significant difference. Angiographic follow-up to 6 months after implantation showed similar late loss and restenosis rates.CONCLUSION:The use of two different alloys, stainless steel and cobalt–chrome stents, in the same patient and in the same vessel produced similar 6-month restenosis and late loss rates.

The SSTARS (STeroids and Stents Against Re-Stenosis) Trial: Different stent alloys and the use of peri-procedural oral corticosteroids to prevent in-segment restenosis after percutaneous coronary intervention

“…In keeping with our findings there was no difference in this outcome 27 . Their study design was different from our study in that both types of stents were 12 implanted in the same patient but either in different vessels or in the same vessel if a gap greater than 10 mm could be left between the stents.…”

Cardiology in Brazilian scientific journals: an overview

“…In general, statin therapy had a better effect on the aortas of the tricuspid than it did on those of the bicuspid patients. Abreu Filho et al [15] evaluated the influence of the alloy and the profile of coronary stents on late loss and re-stenosis rates 6 months after implantation in 187 patients with multi-vessel coronary disease. At least one cobalt-chromium and one stainless steel stent were implanted per patient.…”

Association between diabetes mellitus and primary restenosis following endovascular treatment: a comprehensive meta-analysis of randomized controlled trials

“…Patients not on this regimen were administered an intravenous bolus of 500 mg acetylsalicylic acid and an oral loading dose of 600 mg clopidogrel before or immediately after the procedure. After sheath placement, a bolus of 5,000 U of heparin was administered All patients had to be maintained on clopidogrel (75 mg/day) for at least 1 month and on acetylsalicylic acid (100 mg/day) indefinitely after the procedure Age 63.6 Male sex 497 (75.3%) Restenosis 6 32 Treatment Not available Risk factors Hypertension 485 (73.5%) Hyperlipemia 416 (63%) Current smoker 397 (60.2%) Study design Randomization RCT Blinding Not blinded Center Multicenter, Europe Endpoint of interest QA-R Comparison Balloon-expandable stent vs. self-expanding stent Follow-up 1 year Artery Femoropopliteal Arteries IMAP [ 63 ] 2011 The study included patients with stable angina or acute coronary syndrome (unstable angina or myocardial infarction) with de novo multivessel coronary artery lesions of ≥ 70% by quantitative coronary angiographic analysis who were suitable for stent implantation Patients were excluded if there was failure to provide written informed consent, contraindication to any emergency myocardial revascularization surgery, patients with single-vessel disease, restenotic lesions, chronic total occluded lesions, significant left main disease, patients undergoing primary angioplasty, contraindications to the use of acetylsalicylic acid or clopidogrel and a left ventricular ejection fraction of < 30%. Patients with cardiogenic shock, malignancies or other comorbidities with life expectancy < 12 months or that may result in noncompliance with the protocol, or pregnancy were considered ineligible for the study <...…”