Background: Recent study showed drug-eluting stent (DES) dramatically reduced restenosis rate compared to bare metal stent. However, there was no randomized study comparing DES and thin-strut cobalt chrome alloy stent. Objective: This study was to compare the efficacy of the cobalt chrome alloy stent with thin strut and paclitaxel-eluting stent. Methods: This study was designed as a multicenter prospective randomized study comparing VISION® stent and TAXUS® stent. Inclusion criteria were 1) stable or unstable angina or silent ischemia 2) treated lesion number £ 2 in separate vessels 3) target lesion stenosis is 50 - 95%, 3) native vessel stentable with at least 3.0-4.0 mm stent, and 4) lesions fully covered by one stent (length £ 28 mm). Coronary angiography was evaluated qualitatively and quantitatively in the core lab. Results: Total 487 patients (male 321 patients) from 11 centers in Korea were included in this study. The baseline characteristics were similar between VISION (V) and TAXUS (T) groups. However, the T group was associated with higher proportion of left anterior descending artery location (V 34.7%, T 50.2%, p=0.001), type B2/C lesions (V 27.5%, T 40.9%, p=0.002). There were 1 myocardial infarction (MI) in V group and 1 death in T group for 30 days after the procedure. Currently, the 9-month clinical follow-up was completed in 210 patients (expected date of complete follow-up is December 2005). Death, MI, or revascularization rate was higher in V group (V 11.5%, T 2.8%, p=0.014). Target lesion revascularization rate was also higher in VISION group (V 8.6%, T 2.0%, p=0.04). Conclusion: Paclitaxel-eluting stent seems to be associated with lower long term cardiac event rate compared to thin-strut bare metal stent, although the lesion characteristics were more unfavorable.
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