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(Circulation. 1995;92:693-696.)
© 1995 American Heart Association, Inc.

Articles

American College of Cardiology Meeting Highlights

James J. Ferguson, III, MD

From St Luke's Episcopal Hospital, Texas Heart Institute, Baylor College of Medicine, and the University of Texas Health Science Center at Houston.

	Heparin-Coated Stents: The BENESTENT Study

 
Dr Patrick Serruys from the Thoraxcenter in Rotterdam presented the preliminary results of the BENESTENT II pilot study, a trial designed to evaluate the safety of reducing or eliminating anticoagulant therapy in patients treated with heparin-coated balloon-expandable coronary stents.

The trial was designed in four sequential phases: in phase I, heparin was reinstituted 6 hours after sheath removal, followed by coumadin; in phase II, heparin therapy resumed 12 hours after sheath removal, also followed by coumadin; in phase III, heparin therapy resumed 18 hours after sheath removal, again followed by coumadin; and in phase IV, heparin and coumadin were not used after sheath removal—rather, patients were treated with ticlopidine. Patients in all four groups received aspirin (250 mg/d), dipyridamole (75 mg TID), and diltiazem (120 mg BID). Dextran was administered perioperatively, procedural heparin was administered according to activated coagulation times, and heparin-coated Palmaz-Schatz balloon-expandable stents were used. Vein graft lesions were excluded from the study.

A total of 207 patients were enrolled at 32 clinical centers; 202 patients underwent stent placement. Enrollment commenced in February 1994 and ended in November 1994. There were no instances of stent thrombosis in any of the groups. The incidence of vascular surgery (5.9%, 4.1%, 2.0%, and 0% in groups I, II, III, and IV, respectively) and blood transfusion (2.0%, 0%, 2.0% and 0% in groups I, II, III, and IV) declined with less intense anticoagulation. In-hospital lengths of stay were reduced dramatically from 7.4 days in group 1 to 3.0 days in group IV.

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