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Clinical research

Comparison of everolimus-eluting and paclitaxel-eluting coronary stents in patients with two treated vessels: 2-year results from the SPIRIT III randomised trial

1. Wake Forest University Health Sciences, Medical Center Blvd., Winston-Salem, NC, USA; 2. The Heart Center of IN, Indianapolis, IN, USA; 3. St. Patrick Hospital, Missoula, MT, USA; 4. Abbott Vascular, Santa Clara, CA, USA; 5. Columbia University Medical Center, The Cardiovascular Research Foundation, New York, NY, USA

Aims: To examine the two year clinical outcomes in dual-vessel disease from the SPIRIT III trial comparing the XIENCE V® everolimus-eluting stent (EES) to the TAXUS Express2™ paclitaxel-eluting stent (PES).

Methods and results: From a total of 1,002 randomised subjects, 103 and 51 patients in the EES and PES groups respectively underwent stenting of two lesions in two vessels (one lesion per epicardial vessel). Two-year event rates were lower in one compared to two-vessel treated patients regardless of stent type. For EES vs. PES, major adverse cardiac events (MACE=cardiac death, MI or TLR) was clinically reduced 35.0% in the single vessel patients (6.5% vs. 9.6%, p=0.09) and was significantly reduced 64% in dual vessel patients (11.9% vs. 30.1%, p=0.006). There was no significant interaction between stent type (EES vs. PES) and the number of stented vessels (two vs. single) for either 2-year TVF and MACE (interaction p values were 0.69 and 0.16, respectively).

Conclusions: In the SPIRIT III randomised trial, patients with both single and dual vessel treatment with EES showed improved clinical outcomes at two years compared to those treated with PES. Follow-up to five years is ongoing.

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