Key result
The NEVO sirolimus-eluting stent resulted in a 2-year MACE rate of 7.2% compared to 13.0% with the TAXUS paclitaxel-eluting stent (p=0.086).
Why the study?
Does the NEVO sirolimus-eluting coronary stent improve angiographic and clinical outcomes compared to the TAXUS paclitaxel-eluting stent in patients with single de novo native coronary artery lesions?
RCT (n=394)
randomised
Yes
Does the NEVO sirolimus-eluting coronary stent improve angiographic and clinical outcomes compared to the TAXUS paclitaxel-eluting stent in patients with single de novo native coronary artery lesions?
Absolute Event Rate: 7.2% vs 13%
p-value: p=0.086
The NEVO sirolimus-eluting stent demonstrated sustained numerical advantages in clinical outcomes over the TAXUS paclitaxel-eluting stent up to two years, though the trial was not powered for clinical endpoints.
Nonsignificant MACE trend with NEVO does not change stent selection; leaves open clinical superiority over TAXUS in adequately powered trials.
AIMS: To assess the two-year clinical follow-up of the NEVO RES-1 study, a randomised comparison between the NEVO™ sirolimus-eluting coronary stent system (NEVO SES) and the TAXUS Liberté™ paclitaxel-eluting stent (TAXUS PES). METHODS AND RESULTS: NEVO RES-I randomised 394 patients with single de novo lesions with a maximum length of 28 mm and diameter of 2.5-3.5 mm to NEVO SES (n=202) versus TAXUS PES (n=192). Six-month angiographic results demonstrated the superiority of the NEVO SES over the TAXUS PES for the primary endpoint, in-stent late loss. At one year, MACE (death, emergent CABG, TLR, and MI) in the NEVO SES group was 6.1% versus 10.6% in the TAXUS PES group (p=0.139). After two years, MACE was 7.2% in the NEVO SES group versus 13.0% in TAXUS PES group (p=0.086). Corresponding rates of TLR were 3.6% versus 7.6% (p=0.116). No ARC-defined definite or probable stent thromboses (ST) were reported with NEVO SES while two occurred with TAXUS PES. CONCLUSIONS: While not designed or powered for clinical endpoints, individual and composite clinical endpoints numerically favoured the NEVO SES over the TAXUS PES, with continued separation over time up to two years. No ARC-defined definite or probable ST was reported in the NEVO SES group at two years. Clinical trial identifier: NCT00606333 http://www.clinicaltrials.gov.
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Abizaid et al. (2013) conducted an RCT in de novo native coronary artery lesions (n=394). NEVO sirolimus-eluting coronary stent system vs. TAXUS Liberté paclitaxel-eluting stent was evaluated on MACE (death, emergent CABG, TLR, and MI) at two years (p=0.086). The NEVO sirolimus-eluting stent resulted in a 2-year MACE rate of 7.2% compared to 13.0% with the TAXUS paclitaxel-eluting stent (p=0.086).
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