TY - JOUR
T1 - Two-year clinical outcomes with paclitaxel-eluting coronary stents in patients with chronic total occlusions
T2 - Analysis from the TAXUS ARRIVE program
AU - Huang, Pei Hsiu
AU - Yeung, Michael
AU - Lasala, John M.
AU - Cox, David A.
AU - Bowman, Thomas S.
AU - Starzyk, Ruth M.
AU - Dawkins, Keith D.
PY - 2011/6
Y1 - 2011/6
N2 - Aims: 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. Methods and 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. Conclusion: In a "real-world" setting, PES use in CTO was associated with increased MCE compared to simpleuse patients, but achieved long-term outcomes similar to that observed in other complex patient/lesion cases.
AB - Aims: 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. Methods and 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. Conclusion: In a "real-world" setting, PES use in CTO was associated with increased MCE compared to simpleuse patients, but achieved long-term outcomes similar to that observed in other complex patient/lesion cases.
UR - http://www.scopus.com/inward/record.url?scp=79959836726&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8183.2010.00622.x
DO - 10.1111/j.1540-8183.2010.00622.x
M3 - Article
C2 - 21299633
AN - SCOPUS:79959836726
SN - 0896-4327
VL - 24
SP - 232
EP - 240
JO - Journal of Interventional Cardiology
JF - Journal of Interventional Cardiology
IS - 3
ER -