Data from randomized clinical trials have shown the safety and efficacy of the XIENCE
V in selected populations. However, limited data are available comparing the XIENCE
V to the first-generation CYPHER sirolimus-eluting stent. This study aimed to assess
the long-term safety and clinical efficacy of the XIENCE V everolimus-eluting stent
compared to first-generation stents in an unselected patient population. This retrospective
analysis included 6,069 patients treated with CYPHER, TAXUS, and XIENCE stents from
2003 to 2009 at our institution. The patients were followed up for ≥1 year after the
index procedure. The baseline characteristics were generally comparable among the
3 groups, with the exception of a significantly greater prevalence of diabetes mellitus,
systemic hypertension, and a history of angioplasty and coronary bypass surgery among
the XIENCE patients. The XIENCE patients also had a twofold greater rate of type C
lesions. One-year follow-up data were available for 82% of the patients. The 1-year
major adverse cardiovascular events rate was 9.3% for the XIENCE stent versus 9.8%
for the CYPHER stent and 11.5% for the TAXUS stent (p = 0.11). Mortality was lower
in the XIENCE group than in the CYPHER and TAXUS groups (3.6% vs 4.9% vs 7.2%, respectively,
p <0.001), and target lesion revascularization was similar (5.9% vs 5.2% vs 5.6%,
respectively; p = 0.34). Stent thrombosis was lower in the XIENCE patients (0.2% vs
1.2% vs 0.7%, p = 0.007). In conclusion, in a contemporary United States clinical
practice with an unselected patient population, use of the XIENCE V stent was associated
with an improved safety profile and reduction of all-cause mortality and stent thrombosis
compared to first-generation drug-eluting stents. The XIENCE V failed to demonstrate
superiority for overall major adverse cardiovascular events, Q-wave myocardial infarction,
and revascularization rates.
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Article info
Publication history
Published online: February 17, 2012
Accepted:
December 11,
2011
Received in revised form:
December 11,
2011
Received:
October 19,
2011
Footnotes
The Registry Experience at the Washington Hospital Center, DES - XIENCE V (REWARDS XV) study was partially sponsored by Abbott Vascular (Abbott Park, Illinois).
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
