Lee Chi Hang, Tan Huay Cheem, Bee Hwee, Zhang Jun Jie, Soon Chao Yang, Teo Swee Guan, Low Adrian, Lim Yean Teng
Cardiac Department, National University Hospital, Singapore.
J Invasive Cardiol. 2006 Feb;18(2):39-42.
There are fundamental differences between the CYPHER and TAXUS stents, including the drug coatings, polymers and stent platforms. In this registry study, we sought to investigate the procedural success and 30-day outcomes of the patients who were treated with either the CYPHER or TAXUS stents for de novo bifurcation lesions.
A total of 83 patients with 85 de novo bifurcation lesions treated with either the CYPHER or TAXUS stents from June 2002 to May 2004 were recruited for analysis.
True bifurcation lesion, stenosis in both the main vessel and side branch, constituted 39% of the treated lesions. The procedural success was 96% and 93% in CYPHER and TAXUS groups, respectively. Bifurcation stenting was performed in 13% of the overall study population. Two patients each in the CYPHER (8%) and TAXUS (3%) groups had a slight elevation of cardiac enzymes after the procedure. At 30-day follow up, 2 patients in the TAXUS and none in the CYPHER group had subacute stent thrombosis (SAT), leading to myocardial infarction (MI). Urgent target vessel revascularization (TVR) was attempted in these 2 patients, but failed in 1 of them. A total of 6 adverse events (1 stroke, 2 MIs and 3 TVRs) from 4 patients (2 patients with 2 adverse events) in the TAXUS group, and 1 adverse event (TVR) in the CYPHER group were reported. The adverse event rate was slightly, but not significantly, higher in the TAXUS group (7% vs. 4%; p = 1.000).
Our results suggest that the procedural success and 30-day outcomes were similar in patients who had been treated with either the CYPHER or TAXUS stent for de novo bifurcation lesions. The occurrence of SAT in the TAXUS but not in the CYPHER group warrants further evaluation.
CYPHER支架和TAXUS支架之间存在根本差异，包括药物涂层、聚合物和支架平台。在这项注册研究中，我们试图调查接受CYPHER或TAXUS支架治疗初发分叉病变患者的手术成功率和30天预后情况。
选取2002年6月至2004年5月期间接受CYPHER或TAXUS支架治疗的83例患者的85处初发分叉病变进行分析。
真性分叉病变，即主支血管和分支血管均存在狭窄，占治疗病变的39%。CYPHER组和TAXUS组的手术成功率分别为96%和93%。13%的研究总人群接受了分叉处支架置入术。CYPHER组（8%）和TAXUS组（3%）各有2例患者术后心肌酶轻度升高。在30天随访时，TAXUS组有2例患者发生亚急性支架血栓形成（SAT），导致心肌梗死（MI），而CYPHER组无此情况。对这2例患者尝试进行了紧急靶血管血运重建（TVR），但其中1例失败。TAXUS组共报告了4例患者（2例患者发生2次不良事件）的6次不良事件（1次卒中、2次MI和3次TVR），CYPHER组报告了1次不良事件（TVR）。TAXUS组的不良事件发生率略高，但无统计学意义（7%对4%；p = 1.000）。
我们的结果表明，接受CYPHER或TAXUS支架治疗初发分叉病变的患者，其手术成功率和30天预后情况相似。TAXUS组发生SAT而CYPHER组未发生，这值得进一步评估。
