Two-year outcomes after utilization of the taxus paclitaxel-eluting stent in bifurcations and multivessel stenting in the ARRIVE registries

Emmanouil S. Brilakis, John M. Lasala, David A. Cox, Thomas S. Bowman, Ruth M. Starzyk, Keith D. Dawkins

Research output: Contribution to journalArticle

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Abstract

Aims: Examine the incidence of clinical events after utilization of the TAXUS Express paclitaxel-eluting stent (PES) in multivessel and bifurcation coronary stenting in an unselected patient population. Methods and Results: The ARRIVE Program compiled data on 7,492 patients receiving ≥1 TAXUS Express PES, including patients with multivessel stenting (MVS; n = 1,208) and bifurcation stenting (n = 575). Patients were enrolled at procedure start with no mandated inclusion/exclusion criteria; all cardiac events were monitored with independent adjudication of end-points. Compared to simple use (single vessel/single stent) patients undergoing native intervention (N = 2,698), MVS patients had significantly more baseline comorbidities. Both groups had higher 2-year rates of mortality (7.3%[MVS] and 7.5%[bifurcation] vs. 4.2%[simple-use], P < 0.001), myocardial infarction (5.5% and 4.6% vs. 2.2%, P < 0.001 and P = 0.002), target vessel revascularization (15.5% and 14.8% vs. 7.7%, P < 0.001), and Academic Research Consortium definite/probable stent thrombosis (4.3% and 4.4% vs. 1.4%, P < 0.001) than the simple-use group. Conclusions: ARRIVE multivessel and bifurcation stenting patients have significantly higher clinical risk through 2 years compared to simple-use patients. In the absence of large randomized controlled trials in these populations, ARRIVE provides important insight into clinical outcomes over an extended period of time.

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalJournal of Interventional Cardiology
Volume24
Issue number4
DOIs
StatePublished - Aug 2011

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Taxus
Paclitaxel
Stents
Registries
Population
Comorbidity
Thrombosis
Randomized Controlled Trials
Myocardial Infarction
Mortality
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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Two-year outcomes after utilization of the taxus paclitaxel-eluting stent in bifurcations and multivessel stenting in the ARRIVE registries. / Brilakis, Emmanouil S.; Lasala, John M.; Cox, David A.; Bowman, Thomas S.; Starzyk, Ruth M.; Dawkins, Keith D.

In: Journal of Interventional Cardiology, Vol. 24, No. 4, 08.2011, p. 342-350.

Research output: Contribution to journalArticle

Brilakis, Emmanouil S. ; Lasala, John M. ; Cox, David A. ; Bowman, Thomas S. ; Starzyk, Ruth M. ; Dawkins, Keith D. / Two-year outcomes after utilization of the taxus paclitaxel-eluting stent in bifurcations and multivessel stenting in the ARRIVE registries. In: Journal of Interventional Cardiology. 2011 ; Vol. 24, No. 4. pp. 342-350.
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AU - Brilakis, Emmanouil S.

AU - Lasala, John M.

AU - Cox, David A.

AU - Bowman, Thomas S.

AU - Starzyk, Ruth M.

AU - Dawkins, Keith D.

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N2 - Aims: Examine the incidence of clinical events after utilization of the TAXUS A® Express A® paclitaxel-eluting stent (PES) in multivessel and bifurcation coronary stenting in an unselected patient population. Methods and Results: The ARRIVE Program compiled data on 7,492 patients receiving ≥1 TAXUS Express PES, including patients with multivessel stenting (MVS; n = 1,208) and bifurcation stenting (n = 575). Patients were enrolled at procedure start with no mandated inclusion/exclusion criteria; all cardiac events were monitored with independent adjudication of end-points. Compared to simple use (single vessel/single stent) patients undergoing native intervention (N = 2,698), MVS patients had significantly more baseline comorbidities. Both groups had higher 2-year rates of mortality (7.3%[MVS] and 7.5%[bifurcation] vs. 4.2%[simple-use], P < 0.001), myocardial infarction (5.5% and 4.6% vs. 2.2%, P < 0.001 and P = 0.002), target vessel revascularization (15.5% and 14.8% vs. 7.7%, P < 0.001), and Academic Research Consortium definite/probable stent thrombosis (4.3% and 4.4% vs. 1.4%, P < 0.001) than the simple-use group. Conclusions: ARRIVE multivessel and bifurcation stenting patients have significantly higher clinical risk through 2 years compared to simple-use patients. In the absence of large randomized controlled trials in these populations, ARRIVE provides important insight into clinical outcomes over an extended period of time.

AB - Aims: Examine the incidence of clinical events after utilization of the TAXUS A® Express A® paclitaxel-eluting stent (PES) in multivessel and bifurcation coronary stenting in an unselected patient population. Methods and Results: The ARRIVE Program compiled data on 7,492 patients receiving ≥1 TAXUS Express PES, including patients with multivessel stenting (MVS; n = 1,208) and bifurcation stenting (n = 575). Patients were enrolled at procedure start with no mandated inclusion/exclusion criteria; all cardiac events were monitored with independent adjudication of end-points. Compared to simple use (single vessel/single stent) patients undergoing native intervention (N = 2,698), MVS patients had significantly more baseline comorbidities. Both groups had higher 2-year rates of mortality (7.3%[MVS] and 7.5%[bifurcation] vs. 4.2%[simple-use], P < 0.001), myocardial infarction (5.5% and 4.6% vs. 2.2%, P < 0.001 and P = 0.002), target vessel revascularization (15.5% and 14.8% vs. 7.7%, P < 0.001), and Academic Research Consortium definite/probable stent thrombosis (4.3% and 4.4% vs. 1.4%, P < 0.001) than the simple-use group. Conclusions: ARRIVE multivessel and bifurcation stenting patients have significantly higher clinical risk through 2 years compared to simple-use patients. In the absence of large randomized controlled trials in these populations, ARRIVE provides important insight into clinical outcomes over an extended period of time.

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