Interventional cardiology

Everolimus proves superior in real-world analysis

Although drug-eluting stents are known to reduce the risk of restenosis, and hence the need for reintervention, in patients at high risk of 11 restenosis enrolled in randomised clinical trials, there is little ‘real-life’ data currently available. The COMPARE study (second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice) aimed to compare the safety and efficacy of second-generation everolimus and paclitaxel-eluting stents in real-life practice.

One thousand eight hundred patients were randomly assigned to treatment with either a Xience V or a Taxus Liberté stent in a 1:1 ratio. Patients were unaware of which stent they had been assigned to. The primary endpoint was a composite of safety and efficacy (all cause-mortality, myocardial infarction, and target vessel revascularisation) within 12 months.

In the 1797 patients who completed follow-up, the primary endpoint occurred in 56 (6%) of 897 patients in the everolimus-eluting stent group versus 82 (9%) of 903 patients in the paclitaxel-eluting stent group (relative risk 0.69, p value for superiority=0.02). Lower rates of each of the three main components of the primary endpoint were seen in the everolimus group (figure 1). In terms of clinical outcomes, cardiac death, non-fatal myocardial infarction or target lesion revascularisation occurred in 44 (5%) of patients in the everolimus-eluting stent group versus 74 (8%) patients in the paclitaxel-eluting stent group (p value for superiority=0.005). The trial showed …