title: Propensity-matched patient-level comparison of the TAXUS Liberté and TAXUS element (ION) paclitaxel-eluting stents.
abstract: Stent design, metal alloy composition, and strut thickness may influence late lumen loss and clinical outcomes after bare metal stent deployment; however, their impact on outcomes after drug-eluting stent deployment is unknown. Although the TAXUS Liberté and ION paclitaxel-eluting stents use similar polymer and drug, the ION stent incorporates a novel thin-strut platinum chromium metal alloy and cell design. We therefore compared patient-level data from 2,298 subjects enrolled into the TAXUS ATLAS (TAXUS Liberté) and PERSEUS (ION) clinical trials. Propensity-score (1:1) matching was performed to adjust for covariate imbalance between stent types. Twelve-month major adverse cardiac events were less frequent after use of the ION compared to the TAXUS Liberté (12.7% vs 8.3%, p <0.001, unadjusted; 12.0% vs 7.5%, p = 0.007, propensity matched) largely because of decreased non-Q-wave myocardial infarction (MI; 2.9% vs 1.4%, p = 0.01, unadjusted; 3.2% vs 0.9%, p = 0.004, propensity matched). The MI difference was predominantly periprocedural and in patients treated with a single stent. In conclusion, this exploratory post hoc analysis demonstrated that the ION was associated with fewer adverse clinical events than the TAXUS Liberté because of decreased non-Q-wave MI. Stent platform-related variables may influence clinical outcomes after drug-eluting stent use despite similar polymer and drug elution. Differences in adjunctive pharmacotherapy and/or stenting technique may also be contributory.
authors.affiliation: The Christ Hospital Heart and Vascular Center/The Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio, USA.
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Kereiakes
authors.forename: Louis A
authors.initials: LA
authors.lastname: Cannon
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Mark A
authors.initials: MA
authors.lastname: Turco
authors.forename: Tift
authors.initials: T
authors.lastname: Mann
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Mishkel
authors.forename: Thomas
authors.initials: T
authors.lastname: McGarry
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Underwood
authors.forename: Keith D
authors.initials: KD
authors.lastname: Dawkins
mesh_terms: D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D017239:Paclitaxel / Q000008:administration & dosage*; D057216:Propensity Score; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel