Randomized trial comparing the efficacy between different types of paclitaxel-eluting stents: the comparison of efficacy between COroflex PLEASe ANd Taxus stent (ECO-PLEASANT) randomized controlled trial

Am Heart J. 2013 May;165(5):733-43. doi: 10.1016/j.ahj.2013.02.009. Epub 2013 Mar 20.

Abstract

Aims: Paclitaxel-eluting stents (PESs) have been shown to inhibit neointimal hyperplasia after percutaneous coronary intervention. Coroflex Please (B Braun, Melsungen, Germany) is a newly developed PES. We compared the clinical and angiographic efficacy of Coroflex Please with Taxus Liberte (Boston Scientific, Natick, MA) in a real-world practice.

Methods and results: We performed a prospective, open-label, randomized, controlled study that enrolled 945 patients undergoing percutaneous coronary interventions in 18 centers in Korea. The primary end point was clinically driven target vessel revascularization at 9 months. The baseline characteristics were mostly similar and comparable between 2 groups. At 9 months, the incidence of clinically driven target vessel revascularization was 14.6% for Coroflex and 6.4% for Taxus, which was significantly different (hazard ratio 2.43, 95% CI 1.50-3.94, noninferiority P value = 1.000). This is well corroborated by the difference of in-stent late loss between 2 stents (0.71 ± 0.64 mm vs 0.52 ± 0.50 mm, P < .001) by 9-month follow-up angiography (n = 415 vs 215). Among secondary clinical end points, stent thrombosis (definite and probable) for 1 year was 2.2% in Coroflex and 1.3% in Taxus (P = .317). Also, myocardial infarction for 9 months was higher in Coroflex group than that in Taxus (4.9% vs 1.6%, P = .012), which was partly contributed by the higher incidence of periprocedural myocardial infarction in Coroflex arm (2.2% vs 0.3%, P = .028).

Conclusions: Coroflex Please was inferior to Taxus Liberte with regard to clinical and angiographic efficacy.

Trial registration: ClinicalTrials.gov NCT00699543.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Angioplasty, Balloon, Coronary
  • Antineoplastic Agents, Phytogenic / pharmacology
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / surgery*
  • Drug-Eluting Stents
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Male
  • Middle Aged
  • Paclitaxel / pharmacology*
  • Prospective Studies
  • Prosthesis Design
  • Sirolimus / pharmacology*
  • Time Factors
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Phytogenic
  • Immunosuppressive Agents
  • Paclitaxel
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT00699543