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Cre8 Drug Eluting Stent Performance in Daily Cardiology Practice
Umit Yasar Sinan1, Ebru Serin1, Bengisu Keskin-Meric1
1Department of Cardiology, İstanbul University Cardiology Institute, 34096 Istanbul, Turkey.
Insights
The Cre8 polymer-free amphilimus-eluting stent (PF-AES) demonstrated favorable clinical efficacy and safety in real-world cardiology practice. This study confirms its performance is comparable to newer drug-eluting stents (DES).
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Drug-eluting stents (DES) are standard for percutaneous coronary intervention (PCI).
- Key DES performance factors include stent design, alloy, polymer coating biocompatibility, and drug properties.
- Cre8 is a polymer-free amphilimus-eluting stent (PF-AES).
Purpose of the Study:
- To evaluate the clinical efficacy and safety of Cre8 PF-AES in routine cardiology practice.
- To compare Cre8 stent performance against existing drug-eluting stents.
Main Methods:
- Retrospective analysis of patients treated with Cre8 DES between December 2015 and 2016.
- Inclusion criteria: chronic or acute coronary syndrome patients undergoing PCI with Cre8 DES.
- Data collected on patient demographics, lesion characteristics, procedural success, and clinical outcomes.
Main Results:
- 808 lesions in 664 patients were analyzed; mean follow-up was 487 days.
- Procedural success rate was 97.3%.
- Target lesion failure (TLF) occurred in 6.4% of lesions; cardiac death in 3.0%; target vessel revascularization (TVR) in 4.4%.
Conclusions:
- Cre8 stents show clinical efficacy and safety in real-world settings.
- Outcomes are comparable to latest-generation DES in randomized trials.
- Diabetes and ejection fraction were identified as predictors of mortality and TLF.
Background:
In patients undergoing percutaneous coronary intervention (PCI), drug eluting stents (DES) are currently the standard of care. Stent design and alloy composition, biocompatibility of the drug-eluting polymer coating, the antiproliferative agent properties and release are the three main characteristics that affects DES performance. Cre8 (Alvimedica, Istanbul, Turkey) is a polymer-free amphilimus-eluting stents (PF-AES). In this study, we aimed to investigate the clinical efficacy and safety of Cre8 DES in daily cardiology practice.
Methods:
Patients presenting with chronic coronary syndrome (CCS) or acute coronary syndrome (ACS) including unstable angina pectoris (USAP), myocardial infarction with and without ST-segment elevation and treated with PCI using Cre8 DES between December 2015 and 2016 were retrospectively analyzed in this study.
Results:
Between December 2015 and 2016, 808 lesions of 664 patients treated with Cre8 DES in a single center were included in this retrospective analysis. The mean age of study group was 60 years (between 33 and 93 years) and were predominantly consisting of male patients (79.4%). The median follow-up duration was 487 days (min: 30 days, max: 919 days) and two-thirds of all patients presented with ACS. The culprit lesion was on left anterior descending artery (LAD) (40.5%) and right coronary artery (RCA) (25.9%) in most of the patients. The procedural success rate was 97.3%. Most of the lesions were type B1 (40.6%) according to American College of Cardiology/American Heart Association (ACC/AHA) coronary lesion classification. The device oriented primary end-point defined as target lesion failure (TLF) occurred in 52 (6.4%) of 808 lesions. The primary safety end-point was cardiac death in 20 patients (3.0%) and target vessel myocardial infarction in 2 patients (0.3%). Target vessel revascularization (TVR) occurred in 29 patients (4.4%) as primary safety endpoint. Multivariable logistic regression analysis revealed diabetes mellitus and ejection fraction as the predictors of mortality and device oriented primary end-point.
Conclusions:
This trial revealed clinical efficacy and safety of Cre8 stents in real world practice. Device oriented primary end points were similar with previous studies which are randomized, open label in nature and showed the efficacy and safety of Cre8 stent towards latest generation DES.
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