Key result
Cypher stents show no MACE benefit over Taxus stents at 3 years despite lower restenosis.
Why the study?
The long-term comparative effect of Cypher and Taxus stents in unselected Chinese patients in daily practice was unknown.
Cohort (n=682)
No
Absolute Event Rate: 16.4% vs 21.7%
p-value: p=.113
May support comparable long-term outcomes with first-generation DES in Chinese patients; leaves open relevance to contemporary platforms.
BACKGROUND: Although the efficacy and safety of Cypher and Taxus stents for particular patients and lesions had been proven by random clinical trials, their long-term comparative effect for unselected Chinese patients in daily practice is still unknown. METHODS: From April 2004 to April 2005, 682 consecutive patients who were implanted with a Cypher stent (C group: n = 456, 57.3 +/- 10.8 years old) or a Taxus stent (T group: n = 226, 57.2 +/- 10.2 years old) in our center were analyzed. A mean 3 year clinical and 7 month angiographic follow-up was performed. RESULTS: There was no difference in major adverse cardiac events (MACE) rates in the C and T groups (16.4% vs 21.7%; P = .113), and there was also no difference in cardiac death or myocardial infarction (MI) rates in both groups (2.6% vs 1.8%; P = .598, 3.3% vs 3.5%; P = .826 respectively), but target vessel revascularization (TVR) was higher in the T group (10.5% vs 16.4%; P = .036). There was no difference in total stent thrombosis or its components in both groups (total: 3.9% vs 3.5%; P = 1.000, early: 0.2% vs 0.9%; P = .256, late: 0.7% vs 1.3%; P = .404, and very late: 3.1% vs 1.3%; P = .201 respectively). A 7 month angiographic follow-up indicated that both in-stent and in-segment restenosis rate were significantly lower in the C group (11.1% vs 21.0%; P = .034 and 12.2% vs 24.0%; P = .018), and in-stent and in-segment late loss were significantly smaller in the C group (0.18 +/- 0.08 mm vs 0.53 +/- 0.38 mm; P = .000 and 0.17 +/- 0.09 mm vs 0.38 +/- 0.19 mm; P = .000). CONCLUSION: Results from this 3 year follow-up, single-center study showed almost the same effective and safe profile for both Cypher and Taxus stents, except for a better reducing restenosis effect in the Cypher stent.
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Gao et al. (2009) conducted a cohort in Coronary artery disease requiring stenting (n=682). Cypher stent (Sirolimus-Eluting Stent) vs. Taxus stent (Paclitaxel-eluting Stent) was evaluated on major adverse cardiac events (MACE) (p=.113). Cypher stents showed no significant difference in major adverse cardiac events compared to Taxus stents at 3 years (16.4% vs 21.7%; P=0.113), but demonstrated lower restenosis rates.
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