A Multicenter Registry on the Risk-Benefit Balance of Avantgarde Carbofilm- Coated Stent in Real-World Patients at High Risk for Early Discontinuation of Dual Antiplatelet Therapy Undergoing Percutaneous Coronary Intervention: Focus on Diabetic Status

Objective: We aimed to appraise the risk benefit-balance of the Avantgarde Carbofilm-coated stent in patients undergoing percutaneous coronary intervention (PCI) at high risk of premature dual antiplatelet therapy (DAPT) discontinuation. Background: Carbofilm coating may increase the biocompatibility of coronary stents, but their risk-benefit balance according to diabetic status remains unclear. Methods: Patients underwent PCI with the Avantgarde Carbofilm-coated stent and judged by the caring physician at high risk of premature DAPT interruption were retrospectively identified. Subjects were distinguished in 3 groups: non-diabetic (ND), non-insulin-dependent diabetic (NIDDM), and insulin-dependent diabetic (IDDM). Outcomes of interest were major adverse cardiac events (MACE), and their individual components. Results: A total of 619 patients were included: 490 (79.2%) in the ND group, 95 (15.3%) in the NIDDM group, and 33 (5.3%) IDDM group. After 15±7 months, MACE occurred in 6.9% in the ND group, 17.9% in the NIDDM group, and 21.2% in the IDDM group (p<0.001), with similarly trends for death and cardiac death (all p<0.05). Multivariable analysis confirmed that those in the ND group were at lower risk than those in the NIDDM group for MACE and death (respectively p=0.020 and p=0.005). Conclusion: The Avantgarde Carbofilm-coated stent appears associated with favorable results in patients without diabetes mellitus undergoing PCI and judged at high risk of premature DAPT withdrawal.