Comparison of initial efficacy and long-term follow-up of heparin-coated Jostent with conventional NIR stent
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Ender Semiz1, Cengiz Ermiş, Selim Yalçinkaya
1Department of Cardiology, Pamukkale University Medical School, Denizli, Turkey.
Insights
Heparin-coated Jostents showed no significant benefit over uncoated NIR stents in preventing thrombosis or restenosis. Clinical outcomes and angina classification were similar between the two stent types in this comparative study.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials in Medicine
Background:
- Heparin-coated stents are used to reduce thrombotic complications after coronary implantation.
- Conflicting data exists regarding the efficacy of heparin-coated stents compared to uncoated stents, particularly concerning acute complications and long-term outcomes.
Purpose of the Study:
- To compare the angiographic and clinical outcomes of heparin-coated Jostents versus uncoated NIR stents.
- To evaluate differences in acute/subacute thrombosis, major adverse cardiac events, restenosis rates, and functional angina classification.
Main Methods:
- A comparative study involving 426 patients undergoing coronary stent implantation.
- Patients received either heparin-coated Jostent (n=230) or uncoated NIR stent (n=196).
- Primary endpoints included thrombosis, urgent CABG, AMI, or death; secondary endpoints were restenosis and angina classification at various follow-up intervals.
Main Results:
- No significant differences were observed in angiographic success, procedural success, acute thrombosis, or subacute thrombosis between the Jostent and NIR stent groups.
- Major adverse cardiac event rates were similar. Angiographic restenosis rates were 17% for Jostent and 16% for NIR stents.
- Combined clinical and angiographic restenosis rates and functional angina classifications at 1, 6, and 12 months showed no significant differences between groups.
Conclusions:
- Heparin-coated Jostent implantation offers no significant advantage over uncoated NIR stent implantation regarding initial efficacy, thrombosis, or 6-month restenosis rates.
- Long-term clinical outcomes up to 12 months were also comparable between the heparin-coated and uncoated stent groups.
Abstract:
The implantation of heparin-coated stents was reported to be well tolerated, but there are conflicting results about acute in-hospital complications. (sub)acute thrombosis rates, and long-term follow-up compared to uncoated stents. We compared the angiographic and clinical results after coronary placement of two stent models: the heparin-coated premounted Jostent and the uncoated premounted NIR stent. Of 710 patients revascularized, a total of 426 patients received Jostent (n = 230) or NIR stent (n = 196) implantation. The primary end points were acute or subacute thrombosis, urgent CABG, AMI or death, while the secondary end points were the comparison of the restenosis rates of the stents at the 6th month and of the functional angina classification of the stent groups at the 1st, 6th and 12th months. There were no significant differences between the Jostent and NIR stent groups regarding angiographic and procedural success. Acute thrombosis rates in the Jostent and NIR stent groups were similar while no subacute thrombosis was observed in either group. The major adverse cardiac event rates of the groups also did not differ. Angiographic restenosis occurred in 17% of the Jostent group and 16% of the NIR stent group (NS). The combined clinical and angiographic restenosis rate was also similar between the Jo and NIR groups (19% and 18%, respectively). Comparison of functional angina classes at the 1st, 6th and 12th months revealed no significant difference between the study groups. In conclusion, when compared with implantation of an uncoated premounted NIR stent, implantation of a heparin-coated premounted Jostent does not provide any more benefit with respect to initial efficacy, sub(acute) thrombosis and 6-month restenosis rates and 12-month clinical outcomes.
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