Effects of EPC capture stent and CD34+ mobilization in acute myocardial infarction

Minerva Cardioangiol. 2013 Apr;61(2):211-9.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antigens, CD34 / analysis
  • Blood Cell Count
  • Comorbidity
  • Coronary Restenosis / epidemiology
  • Coronary Restenosis / prevention & control
  • Coronary Restenosis / surgery
  • Coronary Thrombosis / epidemiology
  • Coronary Thrombosis / prevention & control
  • Disease-Free Survival
  • Endothelium, Vascular / physiology
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Mobilization*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Regeneration
  • Registries
  • Risk Factors
  • Stents* / adverse effects
  • Treatment Outcome

Substances

  • Antigens, CD34