title: Long-term benefit of the TAXUS Liberté stent in small vessels and long lesions. TAXUS ATLAS program.
abstract: BACKGROUND
  The long-term impact of treating de novo coronary lesions in native vessels and challenging small vessel and long lesion subsets with TAXUS Liberté stents is unknown. This report examines the 3-year efficacy and safety from the TAXUS ATLAS program.
  
  
  RESULTS
  TAXUS ATLAS WH, Small Vessel, and Long Lesion are non-randomized studies comparing TAXUS Liberté (n = 871), TAXUS Liberté 2.25 mm (n = 261), and TAXUS Liberté 38 mm (n = 150) stents, respectively, to case-matched TAXUS Express historical controls. TAXUS Liberté demonstrated comparable 3-year rates of major adverse cardiac events (19.0% vs. 20.2%, P = 0.51) in de novo lesions, reduced target lesion revascularization (TLR, 10.0% vs. 22.1%, P = 0.008) in small vessels, and reduced myocardial infarction (MI, 2.9% vs. 10.4%; P = 0.01) and stent thrombosis (ST, 0.0% vs. 3.9%, P = 0.03) in long lesions vs. TAXUS Express. After propensity score adjustment, no statistically significant effect of TAXUS Liberté on TLR (9.7% vs. 16.9%, P = 0.12) in small vessels or MI (2.9% vs. 7.9%, P = 0.05) in long lesions was noted, although reduced ST (0.0% vs. 2.7%, P = 0.02) remained in long lesions. Multivariate analyses demonstrated that TAXUS Liberté treatment significantly reduced TLR by 66% in small vessels, and MI by 75% in long lesions, vs. TAXUS Express.
  
  
  CONCLUSIONS
  TAXUS Liberté suggests durable 3-year effectiveness in reducing restenosis and improved clinical outcomes in small vessels and long lesions compared with TAXUS Express.
authors.affiliation: Mercy Angiography Unit, Mercy Hospital, Auckland, New Zealand. johnorm@ihug.co.nz
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Mark A
authors.initials: MA
authors.lastname: Turco
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Hall
authors.forename: Louis A
authors.initials: LA
authors.lastname: Cannon
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Yakubov
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lucca
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Charles D
authors.initials: CD
authors.lastname: O'Shaughnessy
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Kozina
authors.forename: Ian C
authors.initials: IC
authors.lastname: Gilchrist
authors.forename: Barry D
authors.initials: BD
authors.lastname: Bertolet
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Worthley
authors.forename: Paul L
authors.initials: PL
authors.lastname: Underwood
authors.forename: Keith D
authors.initials: KD
authors.lastname: Dawkins
mesh_terms: D006801:Humans; D015607:Stents; D020946:Taxus