Abstract

Objective We sought to identify risk factors for clinical driven target lesion revascularization (TLR) in patients treated with Sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario.

Design From January 1, 2003 to May 18, 2005, all patients treated with a Cypher or Taxus were consecutively registered and followed for 9 months. Re-intervention was driven by clinical symptoms.

Setting Western Denmark Heart Registry.

Patients 4432 patients with 6102 lesions treated with a Cypher (n=3791 lesions) or Taxus (n=2311 lesions) Interventions: Percutaneous coronary intervention.

Main outcome measures TLR defined as either new percutaneous coronary intervention or coronary artery bypass graft operation of the target lesion within 9 months from the index procedure.

Results TLR within 9 months was performed in 2.5% of lesions treated with the Cypher stent and in 3.3% of lesions treated with the Taxus stent (odds ratio (OR) 1.36, 95% confidence interval (CI) 1.00 to 1.84). After adjustment by multivariate logistic regression, Taxus stent implantation was an independent predictor of TLR (OR 1.43, 95% CI 1.05 to 1.95). Implantation of >1 stent per lesion (OR 1.62, 95% CI 1.13 to 2.33) and reference diameter <2.8 mm (OR 1.42, 95% CI 1.00 to 2.02) were also identified as independent predictors of TLR.

Conclusions These registry data reflects a real-world clinical scenario with operator-driven use of drug-eluting stents and symptom-driven re-intervention. In this setting use of the Taxus stent, implantation of multiple stents per lesion, and stent implantation in small vessels were independent predictors of TLR.