Coronary artery disease and new stent technology

Coronary artery disease is a pathophysiological process that affects a large number of patients and remains one of the leading causes of mortality up until day. In this thesis we did investigate the natural course of atherosclerosis in a pathophysiology study focusing on possible mechanism. A better understanding of this process and further risk stratification could be of great importance in improvement of outcomes. The outcomes of patients with coronary artery disease have been greatly improved by the introduction of coronary stents. However, the first generation coronary stents are hampered by clinical important complication such as restenosis and stent thrombosis. The main focus of the novel stent technologies described in the second part of this thesis is to improve vascular healing to overcome these limitations. The novel stents have an endothelial progenitor cells attracting layer both solely (Genous stent) and in combination with a intima hyperplasia reducing drug attached (COMBO stent). In international multi-centre randomized trials and registries we collected data on clinical outcomes in patients treated with these stents for coronary artery disease. The first results of the COMBO stent in an all-comer population shows favourable outcomes with low event rates. The results described in this thesis could lead to the introduction of novel safer stent techniques. In combination with a better understanding of the pathophysiology by future research this should lead to better outcomes in patients with coronary artery disease