Comparison of efficacy between paclitaxel-eluting stents with different polymers in terms of major adverse cardiac events and stent thrombosis up to 12 months of clinical follow-up

Abstract

Since the introduction of drug-eluting stents (DESs) in 2002, DESs have become widely accepted for the majority of coronary lesions in patients with stable angina; DESs have even been used in acute coronary syndromes [ 1 Morice M.C. Serruys P.W. Sousa J.E. et al. A randomized comparison of a sirolimus-eluting stent with standard stent for coronary revascularization. N Engl J Med. 2003; 346: 1773-1780 Crossref Scopus (3864) Google Scholar , 2 Lemos P.A. Serruys P.W. Sousa E. Drug eluting stents: costs versus clinical benefit. Circulation. 2003; 107: 3003-3007 Crossref PubMed Scopus (114) Google Scholar , 3 Kereiakes D.J. Hippocrates revisited: the evidence for drug eluting stents. Circulation. 2003; 107: 3012-3014 Crossref PubMed Scopus (32) Google Scholar , 4 Sousa J.E. Costa M.A. Abizaid A. et al. Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries. Circulation. 2001; 103: 192-195 Crossref PubMed Scopus (785) Google Scholar , 5 Lemos P.A. Lee C.H. Degertekin M. et al. Early outcome after sirolimus-eluting stent implantation in patients with acute coronary syndromes. J Am Coll Cardiol. 2003; 41: 2093-2099 Abstract Full Text Full Text PDF PubMed Scopus (166) Google Scholar ]. Previous randomized trials have shown the efficacy of slow-release polymeric sirolimus- (Cypher™; Cordis, Warren, NJ, USA), paclitaxel- (Taxus™; Boston Scientific, Natick, MA, USA), and zotarolimus-eluting stents (Endeavor™; Medtronic, Minneapolis, MN, USA) over bare metal stents in reducing neointimal hyperplasia, late luminal loss, and angiographic restenosis, leading to decreased target lesion revascularization [ 6 Dawkins K.D. Grube E. Guagliumi G. et al. Clinical efficacy of polymer-based paclitaxel-eluting stents in the treatment of complex, long coronary artery lesions from a multicenter, randomized trial: support for the use of drug-eluting stents in contemporary clinical practice. Circulation. 2005; 112: 3306-3313 Crossref PubMed Scopus (299) Google Scholar , 7 Moses J.W. Leon M.B. Popma J.J. et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003; 349: 1315-1323 Crossref PubMed Scopus (4066) Google Scholar , 8 Colombo A. Drzewiecki J. Banning A. et al. Randomized study to assess the effectiveness of slow- and moderate-release polymer-based paclitaxel-eluting stents for coronary artery lesions. Circulation. 2003; 108: 788-794 Crossref PubMed Scopus (974) Google Scholar , 9 Grube E. Silber S. Hauptmann K.E. Mueller R. et al. TAXUS I: six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation. 2003; 107: 38-42 Crossref PubMed Scopus (846) Google Scholar , 10 Tanabe K. Serruys P.W. Grube E. et al. TAXUS III Trial: in-stent restenosis treated with stent-based delivery of paclitaxel incorporated in a slow-release polymer formulation. Circulation. 2003; 107: 559-564 Crossref PubMed Scopus (330) Google Scholar ]. Now, DESs are considered as first-line therapy for de novo lesions.