Final results of the HEALING IIB trial to evaluate a bio-engineered CD34 antibody coated stent (Genous™Stent) designed to promote vascular healing by capture of circulating endothelial progenitor cells in CAD patients

被引:43
作者
den Dekker, Wijnand K. [1 ]
Houtgraaf, Jaco H. [1 ]
Onuma, Yoshinobu [1 ]
Benit, Edouard [2 ]
de Winter, Robbert J. [3 ]
Wijns, William [4 ]
Grisold, Manfred [5 ]
Verheye, Stephan [6 ]
Silber, Sigmund [7 ]
Teiger, Emmanuel [8 ]
Rowland, Stephen M. [9 ]
Ligtenberg, Erik [9 ]
Hill, Jonathan [10 ]
Wiemer, Marcus [11 ]
den Heijer, Peter [12 ]
Rensing, Benno J. [13 ]
Channon, Keith M. [14 ]
Serruys, Patrick W. J. C. [1 ]
Duckers, Henricus J. [1 ]
机构
[1] Erasmus MC, Thoraxctr Rotterdam, NL-3000 CA Rotterdam, Netherlands
[2] Virga Jesse Ziekenhuis, Hasselt, Belgium
[3] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands
[4] Onze Lieve Vrouw Hosp, Aalst, Belgium
[5] Med Univ Klin Graz, Graz, Austria
[6] Middelheim Ziekenhuis, Antwerp, Belgium
[7] Kardiol Klin Dr Muller, Munich, Germany
[8] Hop Henri Mondor, F-94010 Creteil, France
[9] OrbusNeich, Ft Lauderdale, FL USA
[10] Kings Coll Hosp London, London, England
[11] Herz & Diabet Zentrum Nordrhein Westfalen, Bad Oeynhausen, Germany
[12] Amphia Ziekenhuis, Breda, Netherlands
[13] Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
[14] John Radcliffe Hosp, Oxford OX3 9DU, England
关键词
Endothelial progenitor cell; Restenosis; Arterial healing; Re-endothelialization; Stent; Neo-intima hyperplasia; CORONARY-ARTERY-DISEASE; SIROLIMUS; GROWTH; INJURY; ATHEROSCLEROSIS; PROLIFERATION; IMPLANTATION; HYPERPLASIA; RESTENOSIS; DELIVERY;
D O I
10.1016/j.atherosclerosis.2011.06.032
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the safety and efficacy of the Genous (TM) endothelial progenitor cell (EPC) capturing stent in conjunction with HmG-CoA-reductase inhibitors (statins) to stimulate EPC recruitment, in the treatment of patients with de novo coronary artery lesions. Methods and results: The HEALING IIB study was a multi-center, prospective trial, including 100 patients. The primary efficacy endpoint was late luminal loss by QCA at 6-month follow-up (FU). Although statin therapy increased relative EPC levels by 5.6-fold, the angiographic outcome at 6 month FU was not improved in patients with an overall in-stent late luminal loss of 0.76 +/- 0.50mm. The composite major adverse cardiac events (MACE) rate was 9.4%, whereas 6.3% clinically justified target lesion revascularizations (TLRs) were observed. 2 Patients died within the first 30 days after stent implantation due to angiographically verified in-stent thrombosis. At 12 month FU, MACE and TLR increased to 15.6% and 11.5% respectively and stabilized until 24 month FU. 18 Month angiographic FU showed a significant decrease in late luminal loss (0.67 +/- 0.54, 11.8% reduction or 10% by matched serial analysis, P = 0.001). Conclusion: The HEALING IIB study suggests that statin therapy in combination with the EPC capture stent does not contribute to a reduction of in-stent restenosis formation for the treatment of de novo coronary artery disease. Although concomitant statin therapy was able to stimulate EPC recruitment, it did not improve the angiographic outcome of the bio-engineered EPC capture stent. Remarkably, angiographic late loss was significantly reduced between 6 and 18 months. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:245 / 252
页数:8
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