Target lesion revascularisation in patients treated with a sirolimus-eluting or paclitaxel-eluting stent.
OBJECTIVE
To identify risk factors for clinical-driven target lesion revascularisation (TLR) in patients treated with sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario.


METHODS
From 1 January 2003 to 18 May 2005, all patients treated with a Cypher or Taxus stent were consecutively registered and followed for 9 months. Re-intervention was driven by clinical symptoms.


METHODS
Western Denmark Heart Registry.


METHODS
4432 patients with 6102 lesions treated with a Cypher (n = 3791 lesions) or Taxus (n = 2311 lesions) stent.


METHODS
Percutaneous coronary intervention.


METHODS
TLR, defined as either new percutaneous coronary intervention or coronary artery bypass graft operation of the target lesion, within 9 months from the index procedure.


RESULTS
TLR within 9 months was performed in 2.5% of lesions treated with the Cypher stent and in 3.3% of lesions treated with the Taxus stent (OR 1.36, 95% CI 1.00 to 1.84). After adjustment by multivariate logistic regression, Taxus stent implantation was an independent predictor of TLR (OR 1.43, 95% CI 1.05 to 1.95). Implantation of >1 stent per lesion (OR 1.62, 95% CI 1.13 to 2.33) and reference diameter <2.8 mm (OR 1.42, 95% CI 1.00 to 2.02) were also identified as independent predictors of TLR.


CONCLUSIONS
These data from the registry reflect a real-world clinical scenario with operator-driven use of drug-eluting stents and symptom-driven re-intervention. In this setting, use of the Taxus stent, implantation of multiple stents per lesion and stent implantation in small vessels were independent predictors of TLR.
Maeng
Michael
M
Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark. michael.maeng@ki.au.dk
Okkels Jensen
Lisette
L
Rasmussen
Klaus
K
Flensted Lassen
Jens
J
Romer Krusell
Lars
L
Thayssen
Per
P
Thuesen
Leif
L
D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000453:epidemiology / Q000628:therapy*; D023921:Coronary Stenosis / Q000628:therapy*; D003718:Denmark; D016503:Drug Delivery Systems; D004867:Equipment Design; D006801:Humans; D016015:Logistic Models; D017239:Paclitaxel / Q000008:administration & dosage*; D012042:Registries; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D017239:Paclitaxel; D020123:Sirolimus