Effect on Clinical Restenosis of an Ultra‐Thin‐Strut Bare Metal Cobalt‐Chromium Stent Versus a Thin‐Strut Stainless Steel Stent

Objectives

To prospectively compare the impact of ultrathin‐strut cobalt‐chromium (Cro‐Co) bare metal stent (BMS) versus thin‐strut stainless steel (SS) BMS on clinically driven target lesion revascularization (TLR).

Background

Stent characteristics are an important determinant of restenosis. Thinner strut Cro‐Co BMS is associated with a reduction of neointimal formation compared to SS BMS. The advantages of Cro‐Co BMS in a real‐world population is not clear.

Methods

Patients undergoing percutaneous coronary intervention (PCI) with BMS for any reason were enrolled. Patient with multi‐vessel PCI, multi‐lesions PCI, PCI of unprotected left main and coronary grafts were not excluded. They were divided in two groups according to stent type: Cro‐Co or SS group. The primary endpoint was clinically driven TLR at follow‐up.

Results

A total of 383 patients were enrolled: 222 in SS and 161 in Cro‐Co group. During the follow‐up, Cro‐Co patients had a significantly lower occurrence of TLR compared to SS patients (1.9% vs 8.6%, P = 0.006). There were no significant differences for the composite endpoint of death, myocardial infarct, and stroke (4.9% in Cro‐Co group vs 9.5% in SS group, P = 0.119). At multivariate analysis, the variables that were predictors of TLR were: use of SS stent (OR 4.43, P = 0.019) and diabetes (OR 2.84, P = 0.025).

Conclusions

Ultra‐thin strut Cro‐Co BMS is associated with a significant reduction of clinically driven TLR in all comers population with any type of coronary disease complexity. (J Interven Cardiol 2016;29:300–310)