Key result
Paclitaxel-eluting stents cut 5-year MACE by an absolute ~7% to ~13% vs bare-metal stents.
RCT (n=536)
double-blind
randomized
Absolute Event Rate: 20.4% vs 27.6%
p-value: p=0.01
BACKGROUND: The TAXUS II trial was designed to evaluate the safety and efficacy of the commercialized slow-release (SR) and an investigation-only moderate-release (MR) polymer-based TAXUS paclitaxel-eluting stent compared with a bare-metal stent for the treatment of de novo coronary lesions. METHODS AND RESULTS: This prospective, randomized, double-blind, controlled trial enrolled 536 patients in 2 consecutive cohorts to compare TAXUS SR (n=131) and TAXUS MR (n=135) with an identical but uncoated bare-metal stent control (n=270). The present analysis reports final 5-year clinical outcomes of TAXUS II. At 5 years, both TAXUS SR and MR showed superior outcomes compared with control. The 5-year rates of major adverse cardiac events were 27.6%, 20.4%, and 15.1% (P=0.01); rates of target-vessel revascularization were 22.5%, 16.6%, and 9.0% (P=0.004); and rates of target-lesion revascularization were 18.4%, 10.3%, and 4.5% (P<0.001) for the control, TAXUS SR, and TAXUS MR groups, respectively. The rates of all-cause death and myocardial infarction were low and similar between groups, with 2 stent thromboses with bare-metal stents compared with no event beyond 2 years with either of the TAXUS stents. CONCLUSIONS: TAXUS II is the first large TAXUS trial to have reached 5-year follow-up. Both the SR and MR stents lowered the rates of target-vessel and target-lesion revascularization, which indicates their sustained efficacy. Furthermore, the low overall rates of all death, myocardial infarction, and stent thrombosis support the long-term safety of the TAXUS stent system.
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Silber et al. (2009) conducted an RCT in de novo coronary lesions (n=536). TAXUS paclitaxel-eluting stent (slow-release and moderate-release) vs. uncoated bare-metal stent was evaluated on major adverse cardiac events (p=0.01). TAXUS slow-release and moderate-release paclitaxel-eluting stents reduced 5-year major adverse cardiac events compared to bare-metal stents (20.4% and 15.1% vs 27.6%; P=0.01).
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