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Stents differ in revascularisation effect


A Danish registry suggests that patients receiving a Taxus paclitaxel-eluting stent may be more likely to need target lesion revascularisation (TLR) than those receiving a Cypher sirolimus-eluting stent.

Predictors of TLR included the implantation of a paclitaxel-eluting stent, the use of multiple stents per lesion, and stenting in small vessels.

The researchers note: “These registry data reflect a real-world scenario with operator-driven use of drug-eluting stents and symptom-driven re-intervention.”

The few randomised trials to compare the two types of stent suggest there is less angiographic late lumen loss with the Cypher versus Taxus stents, according to Dr Michael Mæng, of Aarhus University Hospital, Denmark, and colleagues.

To examine whether this remained true in a real-world scenario, the investigators studied data on 4,432 patients with 6,102 lesions consecutively registered on the Western Denmark Heart Registry.

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TLR was performed within nine months in 2.5% of the 3,791 lesions treated with the Cypher stent and in 3.3% of the 2,311 lesions treated with the Taxus stent.

After adjustment for potential confounding factors, Taxus stent implantation was an independent predictor of TLR, with an odds ratio (OR) of 1.43.

Other independent predictors of TLR included implantation of more than one stent per lesion, and a reference vessel diameter of less than 2.8mm, with ORs of 1.62 and 1.42, respectively.

The researchers report: “The Taxus stent was an independent predictor of TLR in a real-world population of patients treated with the first two commercially available drug-eluting stents (Cypher and Taxus).

“The greatest difference in TLR between the two drug-eluting stents was observed in small arteries.”

Heart 2007;93:694-7


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