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Published on: January 21, 2020
[Comparison of Rapamycin and Paclitaxel eluting stent in patients with multi-vessel coronary disease]
Ya-ling Han1, Xiao-zeng Wang, Quan-min Jing
1Department of Cardiology, Shenyang General Hospital of People's Liberation Army, Shenyang 110016, China. hanyal@mail.sy.ln.cn
Insights
Both Rapamycin (Cypher) and Paclitaxel (TAXUS) eluting stents demonstrated comparable efficacy and safety in treating multi-vessel coronary diseases. Long-term outcomes were similar, with no significant differences in restenosis or major adverse cardiac events.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Context:
- Multi-vessel coronary artery disease (CAD) necessitates effective revascularization strategies.
- Drug-eluting stents (DES) have revolutionized CAD treatment by reducing restenosis.
- Comparing different DES platforms is crucial for optimizing patient outcomes.
Purpose:
- To compare the efficacy and safety of Rapamycin (Cypher) and Paclitaxel (TAXUS) eluting stents in patients with multi-vessel coronary diseases.
- To evaluate acute and long-term clinical outcomes, including restenosis, major adverse cardiac events, and stent thrombosis.
Summary:
- A randomized trial of 416 patients with multi-vessel CAD compared Cypher and TAXUS stents.
- No significant differences were observed in restenosis, major adverse cardiac events, or event-free survival at a mean follow-up of 19.5 months.
- Both stent types provided comparable safety and efficacy, though a trend towards higher subacute stent thrombosis was noted with TAXUS.
Impact:
- Provides evidence for the comparable long-term performance of Cypher and TAXUS DES in multi-vessel CAD.
- Informs clinical decision-making regarding the choice of DES for complex coronary artery disease.
- Contributes to the understanding of DES safety profiles and potential differences in thrombotic events.
Objective:
To Compare the efficacy and safety of Rapamycin (Cypher) and Paclitaxel (TAXUS) eluting stents for multi-vessel coronary diseases.
Methods:
From June 2003 to December 2004, a total of 416 patients with multi-vessel coronary diseases were randomly treated with Rapamycin (n = 210) and Paclitaxel (n = 206) eluting stents. Patients with left main lesion, acute myocardial infarction, revascularization were not included. Acute and long-term outcomes were compared between the two groups.
Results:
Baseline clinical characteristics, including risk factors of coronary heart disease, coronary lesion type, heart function, rates of success and complication of percutaneous coronary intervention procedure in the two groups were comparable. Number of stents implanted was not significantly different between the two groups (3.24 +/- 1.25 vs 3.19 +/- 1.38, P > 0.05). Mean follow-up duration was (19.5 +/- 8.9) months. Follow-up rate (96.2 vs 95.1%), angina pectoris reoccurrence (4.0 vs 6.1%), restenosis (7.1 vs 9.6%), major adverse cardiac event (6.4 vs 8.8%) and event free survival (93.1 vs 91.3%) during follow-up were not significantly different between the two groups. Subacute stent thrombosis rate tended to be higher in Paclitaxel eluting stent group compared with Rapamycin eluting stent group (1.0% vs 0.5%, P > 0.05). At 6 to 9 months angiographic follow-up, the in-stent minimal lumen diameter (MLD) and the in-segment MLD were similar between the two groups.
Conclusions:
Satisfactory acute and long term outcomes for patients with multi-vessel coronary disease were achieved by both Cypher and TAXUS stent implantation and the safety and efficacy of the two kinds of stents were comparable.
