Drug-Eluting Stents Compared in Dutch Study

Everolimus-eluting stent outperforms second-generation paclitaxel-eluting stent

FRIDAY, Jan. 8 (HealthDay News) -- The everolimus-eluting stent performed better than the second-generation paclitaxel-eluting stent for safety and efficacy in patients undergoing percutaneous coronary intervention (PCI) in the COMPARE study, published online Jan. 8 in The Lancet.

Elvin Kedhi, M.D., of Maasstad Ziekenhuis in Rotterdam, Netherlands, and colleagues randomly assigned 1,800 patients (aged 18 to 85 years) undergoing PCI to receive either an everolimus-eluting stent or a paclitaxel-eluting stent with the patients blinded to the stent used. The researchers' primary end point was a composite of all-cause mortality, myocardial infarction, and revascularization of the target vessel within 12 months.

The researchers found that the primary end point occurred in 6 percent of the patients receiving the everolimus-eluting stent, compared to 9 percent receiving the paclitaxel-eluting stent. Compared to the paclitaxel-eluting stent, the everolimus-eluting stent had lower rates of myocardial infarction (3 versus 5 percent), thrombosis (less than 1 versus 3 percent), and target vessel revascularization (2 versus 6 percent). The incidence of cardiac death, non-fatal myocardial infarction, and target lesion revascularization was 5 percent for the everolimus-eluting stent, compared to 8 percent for the paclitaxel-eluting stent.

"The everolimus-eluting stent is better than the second generation paclitaxel-eluting stent in unselected patients in terms of safety and efficacy. On the basis of our results, we suggest that paclitaxel-eluting stents should no longer be used in everyday clinical practice," the authors write.

The study was supported by unrestricted grants from Abbott Vascular and Boston Scientific, both of which market versions of the stent. One co-author reported financial ties to the companies.

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