Effects of EPC capture stent and CD34+ mobilization in acute myocardial infarction
P Scacciatella1, M D'Amico, M Pennone
1Department of Cardiovascular and Thoracic Diseases, San Giovanni Battista University HospitalTurin, Italy. paolo.scacciatella@tin.it
Insights
Endothelial progenitor cell (EPC) capture stents show promise for acute myocardial infarction (AMI) treatment, demonstrating safety and effectiveness without stent thrombosis. CD34+ cell levels did not correlate with restenosis or disease progression.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- Percutaneous coronary intervention (PCI) is standard for acute myocardial infarction (AMI).
- Limitations of bare-metal stents (BMS) and drug-eluting stents (DES) include in-stent restenosis and stent thrombosis (ST).
- Endothelial progenitor cell (EPC) CD34+ capture stents aim to improve vascular healing and prevent ST.
Purpose of the Study:
- Evaluate the clinical outcomes of AMI patients treated with EPC CD34+ capture stents.
- Describe the mobilization kinetics of CD34+ cells and their clinical correlation post-PCI.
Main Methods:
- Fifty AMI patients received primary PCI with EPC CD34+ capture stents.
- Serial CD34+ cell levels were measured using flow cytometry.
Main Results:
- 100% procedural success with no observed stent thrombosis (ST) at six-month follow-up.
- Major adverse cardiac events (MACE)-free survival was 81.2%.
- Positive correlation found between CD34+ concentration, age, and infarct size; no correlation with restenosis (TLR/TVR).
Conclusions:
- EPC capture stent implantation is safe and effective for AMI, offering an alternative to BMS and DES.
- Plasmatic CD34+ cell concentration does not appear to correlate with coronary restenosis or atherosclerosis progression.
Aim:
Percutaneous coronary intervention (PCI) is the gold standard for the treatment of acute myocardial infarction (AMI), with the main limitation of in-stent restenosis for BMS and late stent thrombosis (ST) for both BMS and DES. Endothelial progenitor cells (EPC) CD34+ capture stents, promoting vascular healing, may be advantageous in preventing ST. Aim of the study is to evaluate the outcomes of AMI patients treated with EPC CD34+ capture stent and describe the mobilization kinetics of CD34+ and their clinical correlation.
Methods:
Fifty AMI patients underwent primary PCI with EPC CD34+ capture stent. Serial assays of CD34+ were performed by flow-cytometric analysis.
Results:
Procedural success rate was 100%. At six-months follow-up cardiac death, myocardial infarction, target lesion revascularization (TLR) and target vessel revascularization (TVR) occurred respectively in 2%, 4%, 10% and 12% of patients. No case of ST was observed. The MACE-free survival was 81,2%. The mean peak value of plasmatic CD34+ was 4.69±3.76 cells/μL. A positive correlation was found between CD34+ concentration, age and infarct area. No correlation was detected between CD34+ concentration and occurrence of TVR, TLR and MACE.
Conclusion:
EPC capture stent implantation seems to be safe and effective in the clinical setting of AMI, representing a possible alternative to BMS and DES. CD34+ cells plasmatic concentration seems not to correlate to coronary restenosis and atheromasic disease progression.
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