5-year data show titanium-nitride-oxide coated stents may be safer than DES
Key takeaways:
- There were no differences in 5-year outcomes for a novel titanium-nitride-oxide-coated stent vs. a drug-eluting stent.
- Reductions in CV death, MI and stent thrombosis favored the novel stent.
In patients with ACS, there were no differences in 5-year risk for cardiac death, MI or target lesion revascularization for those who received titanium-nitride-oxide-coated stents vs. biodegradable polymer drug-eluting stent, data show.
In an analysis of 5-year outcomes from the TIDES-ACS randomized clinical trial presented at EuroPCR, Frederic Bouisset, MD, of Toulouse Rangueil University Hospital, France, and colleagues observed reductions in CV death, MI and stent thrombosis favored the titanium-nitride-oxide (TiNO)-coated stents (Optimax, Hexacath).
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The new generation of TiNO-coated stents, often referred to as bioactive stents, is a cobalt-chromium, thin-strutted stent coated with an ultrathin metallic layer that exposes nitric oxide molecules toward the vascular lumen, Bouisset and colleagues wrote in a simultaneous publication in JAMA Cardiology. Human data show more rapid and complete strut coverage compared with everolimus-eluting stents without the excessive intimal hyperplasia encountered with bare-metal stents.
Bouisset and colleagues analyzed data from 1,491 patients with ACS with at least one de novo lesion from 12 sites across five European countries, enrolled between January 2014 and August 2016. Researchers randomly assigned participants to the TiNO-coated stent (66.3%) or a DES (33.7%). The mean age of patients was 63 years and 24.3% were women. The primary endpoint was a composite of cardiac death, MI or TLR at 12-month follow-up.
At 5 years, the main composite outcome events occurred in 11.2% of patients in the TiNO group vs. 12% in the DES group, for an HR or 0.94 (95% CI, 0.69-1.28; P = .69).
The 5-year rate of individual components of the endpoint favored the TiNO group; the rate of cardiac death was 0.9% vs. 3% (HR = 0.3; 95% CI, 0.13-0.69; P = .005), the rate of MI was 4.6% vs. 7% (HR = 0.64; 95% CI, 0.41-0.99; P = .049) and the rate of stent thrombosis was 1.2% vs. 2.8% (HR = 0.43; 95% CI, 0.2-0.93; P = .034). Rates of ischemia-driven TLR were similar at 7.4% vs. 6.4% (HR = 1.16; 95% CI, 0.77-1.76; P = .47) for the TiNO and DES groups, respectively.
“In ACS patients, titanium-nitride-oxide-coated stents perform as well as DES and appear to be safer,” Bouisset said during a presentation.
Reference:
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Bouisset F, et al. Clinical Hotline: From (N)STEMI to Chronic Coronary Syndromes. Presented at: EuroPCR; May 16-19, 2023; Paris (hybrid meeting).
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