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. 2010 Mar 31;33(4):E33–E38. doi: 10.1002/clc.20483

Increased Restenosis Rates 12 Months After Coronary Implantation of the Sirolimus‐Eluting YUKON‐Choice Stent Compared to the Paclitaxel‐Eluting TAXUS Stent

Johannes Ruef 1,✉, Hans Störger 1, Franz Schwarz 1, Jürgen Haase 1
PMCID: PMC6653429  PMID: 20358534

Abstract

Background

Previously the polymer‐free sirolimus‐eluting YUKON‐Choice stent (A) has demonstrated noninferiority compared to the polymer‐based paclitaxel‐eluting TAXUS stent (B). To test for long‐term equivalency in unselected real‐world coronary lesions of various complexities, we retrospectively compared both stents.

Methods

A total of 410 patients with symptomatic coronary artery disease (CAD) were treated with stent A (n = 205) or stent B (n = 205). Baseline clinical characteristics, lesion location, and length and the number of stents implanted per lesion were equally distributed. Clinical follow‐up with assessment of major adverse cardiac events (MACE) and noncardiac deaths was obtained at 9 and 12 months.

Results

Nominal stent diameter and nominal length of the stented segment were without differences between the groups. The incidence of MACE after 12 months was significantly higher in group A (35.1%) compared to group B (16.6%, P = .001). This was mainly due to increased rates of target‐lesion revascularizations in group A (13.7%) vs group B (4.4%, P = .005). No significant differences in target‐vessel revascularizations and non‐target‐vessel revascularizations were observed. In group B, 1 stent thrombosis was documented (0.5%) vs none in group A (P > .05); in each group 1 myocardial infarction (MI), but no cardiac deaths occurred; 3 noncardiac deaths in group A (1.5%) vs 7 in group B (3.4%) were observed (P = .3).

Conclusions

In contrast to our previous findings indicating no differences in MACE between patients treated with the polymer‐free sirolimus‐eluting YUKON‐Choice stent and the polymer‐based paclitaxel‐eluting TAXUS stent at 6 months, we herewith show that 12 months after percutaneous coronary intervention (PCI) of real‐world coronary lesions the YUKON stent appears to be inferior due to increased target‐lesion revascularization (TLR) rates as a consequence of delayed restenosis. Copyright © 2010 Wiley Periodicals, Inc.

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REFERENCES

  • 1. Arjomand H, Turi ZG, McCormick D, Goldberg S. Percutaneous coronary intervention: historical perspectives, current status and future directions. Am Heart J 2003; 146: 787–796. [DOI] [PubMed] [Google Scholar]
  • 2. Stone GW, Moses JW, Ellis SG, et al. Safety and efficacy of sirolimus‐ and paclitaxel‐eluting coronary stents. N Engl J Med 2007; 356: 998–1008. [DOI] [PubMed] [Google Scholar]
  • 3. Sousa JE, Serruys PW, Costa MA. New frontiers in cardiology: drug‐eluting stents, part I. Circulation 2003; 107: 2274–2279. [DOI] [PubMed] [Google Scholar]
  • 4. Kastrati A, Mehilli J, Pache J, et al. Analysis of 14 trials comparing sirolimus‐eluting stents with bare‐metal stents. N Engl J Med 2007; 356: 1030–1039. [DOI] [PubMed] [Google Scholar]
  • 5. Maisel WH. Unanswered questions—drug eluting stents and the risk for stent thrombosis. N Engl J Med 2007; 356: 981–984. [DOI] [PubMed] [Google Scholar]
  • 6. Spaulding C, Daemen J, Boersma E, Cutlip D, Serruys PW. A pooled analysis of data comparing sirolimus‐eluting stents with bare‐metal stents. N Engl J Med 2007; 356: 989–997. [DOI] [PubMed] [Google Scholar]
  • 7. Lagerquist B, Lames SK, Stenestrand U, Lindbäck J, Nilsson T. Long‐term outcomes with drug‐eluting stents versus bare‐metal stents in Sweden. N Engl J Med 2007; 356: 1009–1019. [DOI] [PubMed] [Google Scholar]
  • 8. Mehilli J, Kastrati A, Wessely R, et al; for the ISAR‐TEST Trial Investigators. Randomized trial of a nonpolymer‐based rapamycin‐eluting stent versus a polymer‐based paclitaxel‐eluting stent for the reduction of late lumen loss. Circulation 2006; 113: 273–279. [DOI] [PubMed] [Google Scholar]
  • 9. Ruef J, Störger H, Schwarz F, Haase J. Comparison of a polymer‐free rapamycin‐eluting stent (YUKON) with a polymer‐based paclitaxel‐eluting stent (TAXUS) in real‐world coronary artery lesions. Cathet Cardiovasc Interv 2008; 71: 333–339. [DOI] [PubMed] [Google Scholar]
  • 10. Wessely R, Hausleiter J, Michaelis C, et al. Inhibition of neointima formation by a novel drug‐eluting stent system that allows for dose‐adjustable, multiple, and on‐site stent coating. Arterioscler Thromb Vasc Biol 2005; 25: 748–753. [DOI] [PubMed] [Google Scholar]
  • 11. Haase J, Escaned J, Montauban van Swijndregt E, et al. Experimental validation of geometric and densitometric coronary measurements on the new generation cardiovascular angiography analysis system (CAAS II). Cathet Cardiovasc Diagn 1993; 30: 104–114. [DOI] [PubMed] [Google Scholar]
  • 12. Reifart N, Vandormael M, Krajcar M, et al. Randomized comparison of angioplasty of complex coronary lesions at a single center. Excimer Laser, Rotational Atherectomy, and Balloon Angioplasty Comparison (ERBAC) Study. Circulation 1997; 96: 91–98. [DOI] [PubMed] [Google Scholar]
  • 13. Haase J, Störger H, Hofmann M, et al. Comparison of stainless steel stents coated with turbostratic carbon and uncoated stents for percutaneous coronary interventions. J Invasive Cardiol 2003; 15: 562–565. [PubMed] [Google Scholar]
  • 14. Serruys PW, Daemen J. Are drug‐eluting stents associated with a higher rate of late thrombosis than bare metal stents? Late stent thrombosis: a nuisance in both bare metal and drug‐eluting stents. Circulation 2007; 115: 1433–1439. [DOI] [PubMed] [Google Scholar]
  • 15. Wessely R, Kastrati A, Schömig A. Late restenosis in patients receiving a polymer‐coated sirolimus‐eluting stent. Ann Intern Med 2005; 143: 392–394. [DOI] [PubMed] [Google Scholar]
  • 16. Joner M, Finn AV, Farb A, et al. Pathology of drug‐eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 2006; 48: 193–202. [DOI] [PubMed] [Google Scholar]
  • 17. Van der Giessen WJ, Lincoff AM, Schwartz RS, et al. Marked inflammatory sequelae to implantation of biodegradable and nonbiodegradable polymers in porcine coronary arteries. Circulation 1996; 94: 1690–1697. [DOI] [PubMed] [Google Scholar]
  • 18. Dibra A, Kastrati A, Mehilli J, et al. Influence of stent surface topography on the outcomes of patients undergoing coronary stenting: a randomized double‐blind controlled trial. Cathet Cardiovasc Interv 2005; 65: 374–380. [DOI] [PubMed] [Google Scholar]
  • 19. Schömig A, Dibra A, Windecker S, et al. A meta‐analysis of 16 randomized trials of sirolimus‐eluting stents versus paclitaxel‐eluting stents in patients with coronary artery disease. J Am Coll Cardiol 2007; 50: 1373–1380. [DOI] [PubMed] [Google Scholar]
  • 20. Adriaenssens T, Mehilli J, Wessely R, et al. Does addition of estradiol improve the efficacy of a rapamycin‐eluting stent? J Am Coll Cardiol 2007; 49: 1265–1271. [DOI] [PubMed] [Google Scholar]
  • 21. Iakovou I, Schmidt T, Bonizzoni E, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug‐eluting stents. JAMA 2005; 293: 2126–2130. [DOI] [PubMed] [Google Scholar]
  • 22. Nordmann AJ, Briel M, Bucher HC. Mortality in randomized controlled trials comparing drug‐eluting vs. bare metal stents in coronary artery disease: a meta‐analysis. Eur Heart J 2006; 27: 2784–2814. [DOI] [PubMed] [Google Scholar]

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