Increased restenosis rates 12 months after coronary implantation of the sirolimus-eluting YUKON-choice stent compared to the paclitaxel-eluting TAXUS Stent

Clin Cardiol. 2010 Apr;33(4):E33-8. doi: 10.1002/clc.20483.

Abstract

Background: Previously the polymer-free sirolimus-eluting YUKON-Choice stent (A) has demonstrated noninferiority compared to the polymer-based paclitaxel-eluting TAXUS stent (B). To test for long-term equivalency in unselected real-world coronary lesions of various complexities, we retrospectively compared both stents.

Methods: A total of 410 patients with symptomatic coronary artery disease (CAD) were treated with stent A (n = 205) or stent B (n = 205). Baseline clinical characteristics, lesion location, and length and the number of stents implanted per lesion were equally distributed. Clinical follow-up with assessment of major adverse cardiac events (MACE) and noncardiac deaths was obtained at 9 and 12 months.

Results: Nominal stent diameter and nominal length of the stented segment were without differences between the groups. The incidence of MACE after 12 months was significantly higher in group A (35.1%) compared to group B (16.6%, P = .001). This was mainly due to increased rates of target-lesion revascularizations in group A (13.7%) vs group B (4.4%, P = .005). No significant differences in target-vessel revascularizations and non-target-vessel revascularizations were observed. In group B, 1 stent thrombosis was documented (0.5%) vs none in group A (P > .05); in each group 1 myocardial infarction (MI), but no cardiac deaths occurred; 3 noncardiac deaths in group A (1.5%) vs 7 in group B (3.4%) were observed (P = .3).

Conclusions: In contrast to our previous findings indicating no differences in MACE between patients treated with the polymer-free sirolimus-eluting YUKON-Choice stent and the polymer-based paclitaxel-eluting TAXUS stent at 6 months, we herewith show that 12 months after percutaneous coronary intervention (PCI) of real-world coronary lesions the YUKON stent appears to be inferior due to increased target-lesion revascularization (TLR) rates as a consequence of delayed restenosis.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Disease / drug therapy*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / epidemiology*
  • Drug-Eluting Stents*
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / epidemiology
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Male
  • Paclitaxel / administration & dosage*
  • Prosthesis Design
  • Retrospective Studies
  • Sirolimus / administration & dosage*
  • Treatment Outcome
  • Tubulin Modulators / administration & dosage*

Substances

  • Immunosuppressive Agents
  • Tubulin Modulators
  • Paclitaxel
  • Sirolimus