Everolimus-eluting versus paclitaxel-eluting stents.

摘要

The COMPARE trial by Elvin Kedhi and colleagues (Jan 16, p 201) adds to the large body of published data on the treatment of coronary-artery disease with paclitaxel-eluting stents, now amounting to about 50000 patients followed up for up to 9 years. COMPARE was unusual in that the primary composite safety and efficacy endpoint was driven by early (<10 days) stent thrombosis, itself underpowered in a study of 1800 patients. As is evident from the data, very early stent thrombosis resulted in non-fatal myocardial infarction and target-vessel revascularisation (TVR)-two of the three components of the primary endpoint. TVR could not have been the result of restenosis at this early stage and must have been attributable to stent thrombosis, which itself is likely to be the consequence of technical issues at the time of the procedure, or complex coronary anatomy, and does not necessarily reflect on the stent type. This finding has not been replicated in other trials of paclitaxel-eluting stents.