title: Two-year clinical outcomes with paclitaxel-eluting coronary stents in patients with chronic total occlusions: analysis from the TAXUS ARRIVE program.
abstract: OBJECTIVE
  To examine the incidence of clinical events after implantation of the TAXUS Express paclitaxel-eluting stent (PES) in chronic total occlusions (CTO) in an unselected patient population.
  
  
  RESULTS
  The TAXUS ARRIVE registries compiled data on 7,492 patients, including 113 patients with CTO (TIMI flow 0). Patients enrolled at procedure start with no mandated inclusion/exclusion criteria; all cardiac events were monitored with independent end-point adjudication. Two-year follow-up was 89% (101/113) for CTO patients who had significantly more baseline comorbidities/complex disease than simple-use patients undergoing native coronary intervention (N = 2,698) and significantly longer lesions/smaller vessels than other expanded-use patients (N = 4,681 without CTO). Among CTO patients the rate of 2-year major cardiac events (MCE, including cardiac death, myocardial infarction, and target vessel revascularization) was 22.3%, significantly higher than in simple-use patients (10.3%, P < 0.001). CTO MCE was similar to that for other expanded-use patients (16.5%, P = 0.14) but target lesion revascularization was significantly higher in year 2 (6.9% vs. 2.7%, P = 0.02). Academic Research Consortium definite/probable stent thrombosis through 2 years was 5.7%, significantly higher than simple-use patients but similar to other expanded-use cases.
  
  
  CONCLUSIONS
  In a "real-world" setting, PES use in CTO was associated with increased MCE compared to simple- use patients, but achieved long-term outcomes similar to that observed in other complex patient/lesion cases.
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Pei-Hsiu
authors.initials: PH
authors.lastname: Huang
authors.forename: Michael
authors.initials: M
authors.lastname: Yeung
authors.forename: John M
authors.initials: JM
authors.lastname: Lasala
authors.forename: David A
authors.initials: DA
authors.lastname: Cox
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Bowman
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Starzyk
authors.forename: Keith D
authors.initials: KD
authors.lastname: Dawkins
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D015331:Cohort Studies; D054059:Coronary Occlusion / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel