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CYPHER Vs TAXUS A Comparative Analysis of Late Loss Patterns in Drug-Eluting Stents. CYPHER Vs TAXUS. Authors R.R. Sapra, U. Kaul, R.K. Gupta, B. Singh, T. Ghose, R. Kachru, R.B. Thasan. Institution Batra Hospital and Medical Research Centre, New Delhi, India. CYPHER Vs TAXUS. Background
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CYPHER Vs TAXUS • A Comparative Analysis of Late Loss Patterns in Drug-Eluting Stents
CYPHER Vs TAXUS • Authors • R.R. Sapra, U. Kaul, R.K. Gupta, B. Singh, T. Ghose, R. Kachru, R.B. Thasan. • Institution • Batra Hospital and Medical Research Centre, New Delhi, India
CYPHER Vs TAXUS • Background • Drug-eluting stents have emerged as a potential solution for the prevention of restenosis. • Both sirolimus- and paclitaxel-eluting stents have shown significant reduction in restenosis. • Objective • To evaluate and compare the patterns of late loss in sirolimus- (Cypher, Cordis Europa, The Netherlands) and paclitaxel-eluting (Taxus, Boston Scientific, Galway, Ireland) stents.
CYPHER Vs TAXUS • Patients • 288 patients (pts) with 299 lesions • Treatment period: June 2002 to April 2003 • Stents Used • 191 Cypher and 152 Taxus stents. • Ten predictors of late loss were studied.
CYPHER Vs TAXUS • Baseline Features • Mean lesion length was 18.9 ± 6.9 mm and 17.1 ± 3.6 mm for the Cypher and the Taxus stents, respectively. • Mean reference vessel diameter (RVD) was 2.81 ± 0.26 mm and 2.97 ± 0.35 mm for the Cypher and the Taxus stents, respectively.
CYPHER Vs TAXUS Mean lesion length was 18.9 ± 6.9 mm and 17.1 ± 3.6 mm for the Cypher and the Taxus stents, respectively.
CYPHER Vs TAXUS Mean Reference Vessel Diameter was 2.81± 0.26 mm and 2.97 ± 0.35 mm for the Cypher and the Taxus stents, respectively.
CYPHER Vs TAXUS • Current status • Follow-up angiography with qualitative coronary angioplasty is being performed in all pts after 6 months. • Data for 63 consecutive pts (44 Cypher and 23 Taxus) and 70 lesions (46 Cypher and 24 Taxus) were presented at the TCT 2003.
CYPHER Vs TAXUS • Results • Late loss, of more than 25%, in the stented segments* was analyzed and observed in: • 29.2% of Taxus • 19.6% of Cypher stents (p = NS). • Angiographic restenosis (>50% diameter stenosis) was observed in 8.3% of Taxus and 10.8% of Cypher stents (p = NS). • Late loss was focal (< 10 mm long) in all pts. *stent and 5 mm proximal and distal to it
CYPHER Vs TAXUS Angiographic restenosis (>50% diameter stenosis)
CYPHER Vs TAXUS • Results (Cont…) • Late loss in the Taxus stents was present only inside the stent, with no edge effect. • In the Cypher stents, however, the late loss was observed inside the stent in 44.4% lesions and predominantly in the peristent region in the remaining lesions.
CYPHER Vs TAXUS • Univariate analysis factors that appeared to predict late loss were: • presence of diabetes • lesion length >20 mm • (p = 0.07 and 0.09, respectively).
CYPHER Vs TAXUS • Conclusion • Late loss of more than 25% tends to occur more often with Taxus stents compared with Cypher stents. • This did not increase the incidence of 6-month angiographic restenosis. • Late loss was invariably focal, and was observed exclusively inside the stent in Taxus stents, whereas there was significant edge effect observed with Cypher stents. • Diabetes and lesion length >20 mm appear to be predisposing factors.