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Two-Year Clinical Outcomes with Paclitaxel-Eluting Coronary Stents in Patients with Chronic Total Occlusions: Analysis from the TAXUS ARRIVE Program.
MedLine Citation:
PMID:  21299633     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims: To examine the incidence of clinical events after implantation of the TAXUS Express paclitaxel-eluting stent (PES) in chronic total occlusions (CTO) in an unselected patient population. Methods and Results: The TAXUS ARRIVE registries compiled data on 7,492 patients, including 113 patients with CTO (TIMI flow 0). Patients enrolled at procedure start with no mandated inclusion/exclusion criteria; all cardiac events were monitored with independent end-point adjudication. Two-year follow-up was 89% (101/113) for CTO patients who had significantly more baseline comorbidities/complex disease than simple-use patients undergoing native coronary intervention (N = 2,698) and significantly longer lesions/smaller vessels than other expanded-use patients (N = 4,681 without CTO). Among CTO patients the rate of 2-year major cardiac events (MCE, including cardiac death, myocardial infarction, and target vessel revascularization) was 22.3%, significantly higher than in simple-use patients (10.3%, P < 0.001). CTO MCE was similar to that for other expanded-use patients (16.5%, P = 0.14) but target lesion revascularization was significantly higher in year 2 (6.9% vs. 2.7%, P = 0.02). Academic Research Consortium definite/probable stent thrombosis through 2 years was 5.7%, significantly higher than simple-use patients but similar to other expanded-use cases. Conclusion: In a "real-world" setting, PES use in CTO was associated with increased MCE compared to simple- use patients, but achieved long-term outcomes similar to that observed in other complex patient/lesion cases. (J Interven Cardiol 2011;**:1-9).
Authors:
Pei-Hsiu Huang; Michael Yeung; John M Lasala; David A Cox; Thomas S Bowman; Ruth M Starzyk; Keith D Dawkins
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-7
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  -     ISSN:  1540-8183     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©2011, Wiley Periodicals, Inc.
Affiliation:
From Washington University School of Medicine, St. Louis, Missouri Lehigh Valley Hospital, Allentown, Pennsylvania Boston Scientific Corporation, Natick, Massachusetts.
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