TIOMAX: A Spanish Multicenter Registry of the real–world use of the TItanium OptiMAX® biostent: TIOMAX: Registro Español Multicéntrico Del Biostent De Titanio OptiMAX® En La Vida Real

Objectives To compare the safety and efficacy of the new cobalt‐chromium bioactive stent Titan Optimax® (Hexacath, France) with its predecessor, Titan‐2®. Background The TIOMAX registry includes 784 patients who underwent percutaneous coronary intervention with these stents in 21 Spanish hospitals. Methods Analysis of all patients in the registry without exclusion criteria, candidates for revascularization (March‐2013/July‐2014). Initially 273 patients received Titan‐2®, and the next 511 received the Optimax® after its launch. Results Mean age was 65.8 ± 13.0 (78.1% men); 49.2% were STEACS patients (n = 322), 29.8% NSTEACS, and 27.3% had stable angina or silent ischemia. Most STEACS patients (76.4% of n = 322) were treated <24 hr after developing symptoms. All‐cause death (D), cardiac death (CD), acute myocardial infarction (AMI), and stent thrombosis (ST) at 1 month were 1.1, 0.8, 0.1, and 0.5%, respectively, with no significant differences between groups. At 1 year, the death rate was 5.5% for Titan‐2 vs. 4.1% for Optimax®, CD was 1.8% for both groups, ST 1.1 vs. 0.6%, new AMI 3.3 vs. 2.5% and target lesion revascularization (TLR) 3.7 vs. 2.9%. The primary endpoint of the composite event (CE) of D/AMI/TLR/ST occurred in 10.3% vs. 7.6% (p = 0.211). Patients with STEACS (N = 322: Titan‐2/Optimax: 103/209) had better outcomes for secondary events, device‐oriented failure CD/AMI/TLR (7.8% vs. 5.0%; p = 0.330), and non‐fatal CE of AMI/ST/TLR (7.8% vs. 2.7%, p = 0.039). Conclusions The Titan Optimax retains the efficacy and safety of Titan 2. It appears to perform better in the subgroup of STEACS patients, by reducing the non‐fatal CE of AMI/ST/TLR.