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Coronary stenting with the Genous™ Bio-Engineered R Stent™ in elderly patients

Peter Damman1, Andres Iñiguez, Margo Klomp

  • 1Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.

Circulation Journal : Official Journal of the Japanese Circulation Society
|September 15, 2011
PubMed

Insights

Elderly patients receiving the Genous Bio-engineered R stent had higher rates of target vessel failure (TVF), primarily due to increased mortality. Stent thrombosis (ST) rates were similar across age groups, indicating safety for older individuals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Elderly patients undergoing percutaneous coronary intervention (PCI) face higher risks of clopidogrel discontinuation.
  • This discontinuation is linked to an increased risk of stent thrombosis (ST).
  • The Genous Bio-engineered R stent was evaluated in this vulnerable population.

Purpose of the Study:

  • To assess the safety and efficacy of the Genous Bio-engineered R stent in elderly patients.
  • To compare outcomes in elderly versus younger patients undergoing PCI.
  • To evaluate the risk of target vessel failure (TVF), target lesion revascularization (TLR), and ST in different age groups.

Main Methods:

  • Analysis of the e-HEALING registry data.
  • Inclusion of 2,651 patients <65, 1,403 patients aged 65-74, and 869 patients ≥75 years.
  • 12-month follow-up assessing TVF, TLR, and ST using Kaplan-Meier and log-rank tests.

Main Results:

  • TVF occurred significantly more frequently in elderly patients (11.7% in ≥75 years) compared to younger patients (7.0% in <65 years; P<0.001).
  • A trend towards higher TLR rates was observed with increasing age (log-rank P=0.06).
  • No significant difference in stent thrombosis (ST) rates was found across age groups.

Conclusions:

  • The Genous stent demonstrated a significantly higher 1-year TVF rate in elderly patients, largely driven by increased mortality.
  • Despite a trend towards higher TLR, the absence of increased ST suggests the therapy is safe for the elderly.
  • This finding is important given concerns about long-term dual antiplatelet therapy in older individuals.
Abstract

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