Long-term safety and efficacy of the everolimus-eluting stent compared to first-generation drug-eluting stents in contemporary clinical practice.
Long-term safety and efficacy of the everolimus-eluting stent compared to first-generation drug-eluting stents in contemporary clinical practice.
- 2014
Available online from MWHC library: 2001 - present, Available in print through MWHC library: 2003 - 2008
BACKGROUND: There are limited long-term data comparing Xience V EES vs the first-generation Cypher SES. CONCLUSIONS: In a contemporary clinical United States practice with an unselected patient population, Xience V EES use was associated with improved safety profile and reduction of all-cause mortality and stent thrombosis when compared to both first-generation drug-eluting stents. This superiority continues to widen from 1 to 2 years. METHODS: This retrospective analysis included 6069 patients treated with Cypher SES, Taxus PES, or Xience V EES from 2003-2009 at our institution. Patients were followed by telephone contact or office visit up to 2 years after the index procedure. OBJECTIVE: This study aimed to assess the long-term safety and clinical effectiveness of the Xience V everolimus-eluting stent (EES) compared to both Taxus paclitaxel-eluting stent (PES) and Cypher sirolimus-eluting stent (SES) in an unselected patient population. RESULTS: Baseline characteristics were generally comparable, with the exception of a significantly higher prevalence of diabetes mellitus, systemic hypertension, history of angioplasty, and coronary bypass surgery among Xience V EES patients. At 2 years, the incidence of major adverse cardiovascular events was 13.3% (Xience V EES) vs 17.8% (Cypher SES) vs 22% (Taxus PES) (P<.001). The main drivers for the differences in event rates were lower mortality, the need for target vessel revascularization, and Q-wave myocardial infarction. Stent thrombosis was lowest in Xience V EES patients (0.2% vs 1.2% SES vs 0.7% PES, respectively; P=.01). A landmark analysis after 1 year showed that the benefits of Xience V EES continued in long-term follow-up.
English
1042-3931
*Coronary Artery Disease/th [Therapy]
*Drug-Eluting Stents
*Percutaneous Coronary Intervention/is [Instrumentation]
*Percutaneous Coronary Intervention/mt [Methods]
*Postoperative Complications/ep [Epidemiology]
*Sirolimus/aa [Analogs & Derivatives]
Aged
Coronary Stenosis/ep [Epidemiology]
Coronary Stenosis/et [Etiology]
Drug-Eluting Stents/ae [Adverse Effects]
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction/ep [Epidemiology]
Myocardial Infarction/et [Etiology]
Paclitaxel
Postoperative Complications/et [Etiology]
Retrospective Studies
Treatment Outcome
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Observational Study
Available online from MWHC library: 2001 - present, Available in print through MWHC library: 2003 - 2008
BACKGROUND: There are limited long-term data comparing Xience V EES vs the first-generation Cypher SES. CONCLUSIONS: In a contemporary clinical United States practice with an unselected patient population, Xience V EES use was associated with improved safety profile and reduction of all-cause mortality and stent thrombosis when compared to both first-generation drug-eluting stents. This superiority continues to widen from 1 to 2 years. METHODS: This retrospective analysis included 6069 patients treated with Cypher SES, Taxus PES, or Xience V EES from 2003-2009 at our institution. Patients were followed by telephone contact or office visit up to 2 years after the index procedure. OBJECTIVE: This study aimed to assess the long-term safety and clinical effectiveness of the Xience V everolimus-eluting stent (EES) compared to both Taxus paclitaxel-eluting stent (PES) and Cypher sirolimus-eluting stent (SES) in an unselected patient population. RESULTS: Baseline characteristics were generally comparable, with the exception of a significantly higher prevalence of diabetes mellitus, systemic hypertension, history of angioplasty, and coronary bypass surgery among Xience V EES patients. At 2 years, the incidence of major adverse cardiovascular events was 13.3% (Xience V EES) vs 17.8% (Cypher SES) vs 22% (Taxus PES) (P<.001). The main drivers for the differences in event rates were lower mortality, the need for target vessel revascularization, and Q-wave myocardial infarction. Stent thrombosis was lowest in Xience V EES patients (0.2% vs 1.2% SES vs 0.7% PES, respectively; P=.01). A landmark analysis after 1 year showed that the benefits of Xience V EES continued in long-term follow-up.
English
1042-3931
*Coronary Artery Disease/th [Therapy]
*Drug-Eluting Stents
*Percutaneous Coronary Intervention/is [Instrumentation]
*Percutaneous Coronary Intervention/mt [Methods]
*Postoperative Complications/ep [Epidemiology]
*Sirolimus/aa [Analogs & Derivatives]
Aged
Coronary Stenosis/ep [Epidemiology]
Coronary Stenosis/et [Etiology]
Drug-Eluting Stents/ae [Adverse Effects]
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction/ep [Epidemiology]
Myocardial Infarction/et [Etiology]
Paclitaxel
Postoperative Complications/et [Etiology]
Retrospective Studies
Treatment Outcome
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Observational Study