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Mid-term Clinical Outcomes of Newer Generation Sirolimus-eluting Stent (Cypher SelectTM) versus Paclitaxel-eluting Stent (Taxus LiberteTM) in an Asian Population
고려대학교 구로병원 순환기내과¹, 을지병원 심장내과², Cardiology Department, the Second Hospital of Tianjin Medical University, Tianjin, China³, Cardiology Department, Nankai Hospital, Tianjin Medical University, Tianjin, China⁴
Kanhaiya L. Poddar¹, 나승운¹, Meera Kumari¹, 박지영², 최병걸¹, Sureshkumar Ramasamy¹, Kang Yin Chen³, Yong Jian Li⁴, 김연경¹, 나진오¹, 최철웅¹, 임홍의¹, 김진원¹, 김응주¹, 박창규¹, 서홍석¹, 오동주¹
Background: Newer generation Cypher and Taxus stents are being made for better outcomes compared to their parent stents and the differences are currently largely unknown. Whether the clinical outcomes of newer generation Cypher Select are better than those of Taxus Liberte is yet to be studied. Method: A total 412 patients (pts) who underwent percutaneous coronary intervention (PCI) were selected. Cypher Select was used from April 2007 to March 2008 in 100 Pts and Taxus Liberte in 312 pts since June 2006 and pts who have completed six months follow up were enrolled for the analysis. Multivariate logistics analysis was used to compare the major clinical outcomes between the two groups at 6 months. Results: More than 35 different variables were compared between the two groups. Baseline characteristics were similar except the Taxus group had more myocardial infarction (MI, 40.7 vs. 27%, P=0.009), less hyperlipidemia (28.5 vs. 45%, P=0.002) but less bifurcation Lesions (22.1 vs. 36%, P=0.005) and less left main lesions (2.6 vs. 7.1%, P=0.04). After multivariate analysis, Cypher Select group showed more major adverse cardiac event (MACE; 19.0 vs. 14.1%, p=0.02, OR-2.59, 95% CI 1.132-5.938) compared to those in Taxus group, mostly from the higher incidence of repeat PCI including TVR in the Cypher group (Table). Conclusions: After the baseline adjustment by multivariate analysis, the pts receiving Cypher Select stents showed higher incidence of MACE compared with that of the Taxus Liberte stent. Further study with larger study populations would be needed to get the final conclusion.

Table. Clinical Outcomes at 6 months

Variables, n (%)

Cypher Select Group.

(n=100 pts.)

Taxus Liberte Group

(n=321 pts.)

P-Value

Mortality

0 (0.0)

5 (1.5), 3 Non Cardiac

--

Q-MI

0 (0.0)

2 (0.6)

--

Non Q-MI

0 (0.0)

6 (1.9)

--

Repeat-PCI

18 (18.0)

40 (12.5)

0.05

TLR-PCI

9 (9.0)

37 (11.5)

0.11

TVR-PCI

14(14.0)

38 (11.8)

0.04

MACE

19 (19.0)

44 (13.7)

0.02

Stent Thrombosis

2(2.0)

3(1.0)

0.35

 



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