Open AccessIn‐stent Restenosis in Bare Metal Stents Versus Sirolimus‐eluting Stents After Primary Coronary Intervention for Acute Myocardial Infarction and Subsequent Transcoronary Transplantation of Autologous Stem Cells
Author(s) -
Steinwender Clemens,
Hofmann Robert,
Kypta Alexander,
Kammler Juergen,
Kerschner Klaus,
Grund Michael,
Sihorsch Kurt,
Gabriel Christian,
Leisch Franz
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20235
Subject(s) - medicine , restenosis , stent , myocardial infarction , cardiology , transplantation , bare metal stent , neointimal hyperplasia , surgery , drug eluting stent
Background Following stenting for acute myocardial infarction, transcoronary transplantation of granulocyte‐colony stimulating factor (G‐CSF) mobilized autologous stem cells (ASC) has been shown to result in an increased in‐stent restenosis rate of bare metal stents (BMS). Hypothesis This study sought to compare the extent of neointimal growth in BMS and sirolimus‐eluting stents (SES) after primary implantation, and subsequent transcoronary transplantation of G‐CSF mobilized stem cells. Methods Patients with stenting of the left anterior descending coronary artery for acute anterior myocardial infarction were randomly assigned to receive a BMS or SES. Intracoronary stem cell injection was performed after G‐CSF application for at least 4 d and cell apheresis. The angiograms obtained after cell transplantation and after 6 mo were analyzed by quantitative coronary angiography. Results We performed primary stenting and stem cell transplantion in 16 patients who received a BMS (n = 8) or an SES (n = 8). In 2 patients with a BMS, late stent thrombosis occurred after 58 d and 177 d, respectively. In the remaining patients, control angiography after 6 mo revealed in‐stent restenosis of >50% in no patients with SES but in 4 patients with BMS (67%). Late lumen loss and in‐stent plaque volume were significantly higher in patients with BMS compared with patients with SES. Conclusions Compared with BMS, SES impair in‐stent intima hyperplasia after stenting for acute myocardial infarction and transcoronary transplantation of G‐CSF mobilized ASC. Copyright © 2008 Wiley Periodicals, Inc.