Procedural success and 30 day outcomes between CYPHER and TAXUS stent implantation for the treatment of bifurcation lesions--a single-center experience.
BACKGROUND
There are fundamental differences between the CYPHER and TAXUS stents, including the drug coatings, polymers and stent platforms. In this registry study, we sought to investigate the procedural success and 30-day outcomes of the patients who were treated with either the CYPHER or TAXUS stents for de novo bifurcation lesions.


METHODS
A total of 83 patients with 85 de novo bifurcation lesions treated with either the CYPHER or TAXUS stents from June 2002 to May 2004 were recruited for analysis.


RESULTS
True bifurcation lesion, stenosis in both the main vessel and side branch, constituted 39% of the treated lesions. The procedural success was 96% and 93% in CYPHER and TAXUS groups, respectively. Bifurcation stenting was performed in 13% of the overall study population. Two patients each in the CYPHER (8%) and TAXUS (3%) groups had a slight elevation of cardiac enzymes after the procedure. At 30-day follow up, 2 patients in the TAXUS and none in the CYPHER group had subacute stent thrombosis (SAT), leading to myocardial infarction (MI). Urgent target vessel revascularization (TVR) was attempted in these 2 patients, but failed in 1 of them. A total of 6 adverse events (1 stroke, 2 MIs and 3 TVRs) from 4 patients (2 patients with 2 adverse events) in the TAXUS group, and 1 adverse event (TVR) in the CYPHER group were reported. The adverse event rate was slightly, but not significantly, higher in the TAXUS group (7% vs. 4%; p = 1.000).


CONCLUSIONS
Our results suggest that the procedural success and 30-day outcomes were similar in patients who had been treated with either the CYPHER or TAXUS stent for de novo bifurcation lesions. The occurrence of SAT in the TAXUS but not in the CYPHER group warrants further evaluation.
Lee
Chi Hang
CH
Cardiac Department, National University Hospital, Singapore.
Tan
Huay Cheem
HC
Bee
Hwee
H
Zhang
Jun Jie
JJ
Soon
Chao Yang
CY
Teo
Swee Guan
SG
Low
Adrian
A
Lim
Yean Teng
YT
D000208:Acute Disease; D000368:Aged; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage* / Q000627:therapeutic use; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage* / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
D017239:Paclitaxel; D020123:Sirolimus