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Paclitaxel Eluting Stent

Paclitaxel Eluting Stent

The current trial sought to compare outcomes between the everolimus-eluting stent (EES) (Xience V) and paclitaxel-eluting stent (PES) (Taxus Liberte) in a real-world situation. Contribution to the Literature: The COMPARE trial showed that EES is superior to PES at 5 years for MI, TVR, stent......

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The current trial sought to compare outcomes between the everolimus-eluting stent (EES) (Xience V) and paclitaxel-eluting stent (PES) (Taxus Liberte) in a real-world situation.
Contribution to the Literature: The COMPARE trial showed that EES is superior to PES at 5 years for MI, TVR, stent thrombosis, and MACE when used in a real-world setting.

Study Design
Patients Enrolled: 1,800
Mean Follow Up: 1 year, 2 years, and 5 years
Female: 30%

Patient Populations:
● Patient is suitable candidate for PCI
● Life expectancy >5 years

Exclusions:
● No dual antiplatelet therapy for 1 year
● Cardiogenic shock at presentation
● Planned major surgery within 1 month
● Participation in another trial

Primary Endpoints:
● All-cause mortality, nonfatal MI, and TVR at 1 year

Secondary Endpoints:
● Cardiac death, nonfatal MI, and ischemia-driven TLR at 1 year, and then annually up to 5 years
● All-cause mortality, nonfatal MI, and TVR at 2-5 years
● Incidence of stent thrombosis annually during 5 years

Drug/Procedures Used:
Patients meeting enrollment criteria were randomized to receive either EES or PES in a 1:1 fashion.

Concomitant Medications:
Glycoprotein IIb/IIIa inhibitors (32%); aspirin 300 mg once, then 100 mg daily for life; clopidogrel 300 or 600 mg once, then 75 mg daily for 12 months

Principal Findings:
A total of 1,800 patients were randomized, 903 to PES and 897 to EES. Baseline characteristics were fairly similar between the two arms. About 25% of patients presented with acute myocardial infarction (MI), and 23% with non-ST-elevation MI. Multivessel disease was noted in 27% of the patients, and 18% were diabetic. Left main stenting was conducted in 2% of the patients. The mean stent length per lesion was 28 mm, and the mean number of lesions was 1.65 per patient.

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