Propensity-Matched Patient-Level Comparison of the TAXUS Liberté and TAXUS Element (ION) Paclitaxel-Eluting Stents
| Autor: | Thomas J. McGarry, John A. Ormiston, Mark Turco, Hong Wang, Dean J. Kereiakes, Tift Mann, Paul Underwood, Louis Cannon, Gregory J. Mishkel, Keith D. Dawkins |
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| Rok vydání: | 2011 |
| Předmět: |
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Bare-metal stent medicine.medical_specialty Paclitaxel medicine.medical_treatment Myocardial Infarction Prosthesis Design Risk Assessment Coronary Restenosis chemistry.chemical_compound Risk Factors Stent deployment Internal medicine medicine Humans cardiovascular diseases Propensity Score Clinical Trials as Topic Chi-Square Distribution biology Metal alloy business.industry Late Lumen Loss Stent Drug-Eluting Stents Middle Aged equipment and supplies biology.organism_classification Tubulin Modulators Logistic Models Treatment Outcome surgical procedures operative Taxus chemistry Cardiology Female Cardiology and Cardiovascular Medicine business Stent design |
| Zdroj: | The American Journal of Cardiology. 108:828-837 |
| ISSN: | 0002-9149 |
| Popis: | Stent design, metal alloy composition, and strut thickness may influence late lumen loss and clinical outcomes after bare metal stent deployment; however, their impact on outcomes after drug-eluting stent deployment is unknown. Although the TAXUS Liberté and ION paclitaxel-eluting stents use similar polymer and drug, the ION stent incorporates a novel thin-strut platinum chromium metal alloy and cell design. We therefore compared patient-level data from 2,298 subjects enrolled into the TAXUS ATLAS (TAXUS Liberté) and PERSEUS (ION) clinical trials. Propensity-score (1:1) matching was performed to adjust for covariate imbalance between stent types. Twelve-month major adverse cardiac events were less frequent after use of the ION compared to the TAXUS Liberté (12.7% vs 8.3%, p0.001, unadjusted; 12.0% vs 7.5%, p = 0.007, propensity matched) largely because of decreased non-Q-wave myocardial infarction (MI; 2.9% vs 1.4%, p = 0.01, unadjusted; 3.2% vs 0.9%, p = 0.004, propensity matched). The MI difference was predominantly periprocedural and in patients treated with a single stent. In conclusion, this exploratory post hoc analysis demonstrated that the ION was associated with fewer adverse clinical events than the TAXUS Liberté because of decreased non-Q-wave MI. Stent platform-related variables may influence clinical outcomes after drug-eluting stent use despite similar polymer and drug elution. Differences in adjunctive pharmacotherapy and/or stenting technique may also be contributory. |
| Databáze: | OpenAIRE |
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