Carbon-coated stents in patients with acute coronary syndromes

For patients with ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI), rapid restoration of coronary blood flow is the primary therapeutic goal. Because of the acute nature of this clinical presentation, bleeding risks may not be adequately evaluated, limiting the use of drug-eluting stents, since premature discontinuation of antiplatelet therapy strongly predicts stent thrombosis. We evaluated angiographic and clinical results of non-drug-eluting carbon-coated stents.

In this prospective observational study, angiographic and clinical 6-mo results of a carbon-coated stent for treatment of acute lesions in native coronary arteries were evaluated. Angiographic main outcome measures included in-stent late loss and binary restenosis rate. Major adverse cardiac events (MACEs) were defined as any death, Q-wave myocardial infarction (MI), and target lesion revascularization.

We included 320 patients with STEMI (n = 205) or NSTEMI (n = 115) with 360 lesions. Reference vessel diameter was 2.93 +/- 0.53 mm and stented length 22.7 +/- 13.8 mm. Angiographic follow-up was available in 220 of 360 lesions (61%). In-stent late loss was 0.69 +/- 0.75 mm, with a binary restenosis rate of 19.1%. For the total segment late loss was 0.74 +/- 0.77 mm and binary restenosis rate 21.4%. Clinical follow-up for 97.4% of discharged patients was available. Hierarchical MACEs were death in 14 patients (4.4%), Q-wave MI in 3 patients (0.9%), and target lesion revascularization in 39 patients (12.2%).

In this prospective, observational study, the use of a carbon-coated stent for treatment of lesions in patients with STEMI or NSTEMI was associated with a low late loss, translating into a low binary angiographic restenosis rate within a 6-mo follow-up.